Choledochoscopic lithotomy with the aid of electrohydraulic lithotripsy ( EHL ) was performed in 12 patients at the Department of Surgery, College of Medicine, the Catholic University of Korea, St. Vincent Hospital between January 1996 and March 1998. This retrospective analysis include 4 patients with common bile duct (CBD) stones, 5 patients with intrahepatic duct (IHD) stones, and 3 patients with CBD & IHD stones. The male to female ratio was 1 to 2. The peak incidence of age was the fifty. As a route for the choledochoscopy, a T-tube tract was used in 9 patients, while percutaneous biliary drainage followed by dilatation of the tract was established in 3 patients. The largest stones measured 22mm (by 5mm), the average is 10.3mm. Average number of session which performed for IHD stones was 3.7, while that of CBD stones was 2.7. Complete removal of the stones was achieved in 7 of 12 patients. Retained stones of CBD were removed completely in all cases. We could not removed retained stones completely in cases of multiple, impacted stones in peripheral ducts, associated stricture and acute angulation of IHD & CHD which choledochoscopic manipulation make difficult. Minor complications were bleeding from the bile duct mucosa in 1 patient and postprocedure chills and fever in 1 patient. In conclusion, choledochoscopic lithotomy with electrohydraulic lithotripsy is efficient and will be useful to remove biliary calculi in patients who have poor surgical risks.
Bile Ducts* ; Bile* ; Chills ; Common Bile Duct ; Constriction, Pathologic ; Dilatation ; Drainage ; Female ; Fever ; Gallstones ; Hemorrhage ; Humans ; Incidence ; Korea ; Lithotripsy* ; Male ; Mucous Membrane ; Retrospective Studies

The left main coronary artery branches to form the left anterior descending and left circumflex arteries and supplies the entire myocardium of the left ventricle. Treatment guidelines recommend coronary artery bypass grafting in left main coronary artery disease. However, some recent studies have demonstrated that, although the target vessel revascularization rate is relatively high, percutaneous coronary intervention (PCI) has a comparable mortality rate to coronary artery bypass grafting in left main disease. In this case, an 80-year-old male with a recent ST elevation myocardial infarction of the right coronary artery (RCA) was transferred to our hospital for second-stage PCI for left main artery stenosis, which was found incidentally at the time of primary PCI of the RCA. Although he had severely depressed left ventricular function, a drug-eluting stent was implanted successfully in his left main coronary artery with percutaneous cardiopulmonary support.
Aged, 80 and over ; Angioplasty, Balloon, Coronary ; Arteries ; Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Vessels ; Drug-Eluting Stents ; Equipment and Supplies ; Extracorporeal Circulation ; Glycosaminoglycans ; Heart Ventricles ; Humans ; Infarction ; Male ; Myocardial Infarction ; Myocardium ; Percutaneous Coronary Intervention ; Stents ; Ventricular Function, Left