Korean Journal of Gastrointestinal Endoscopy 2009;39(1): 50-54.
십이지장 주유두 선종의 내시경 유두절제술 후 발생한 담관염과 담즙 역류를 동반한 췌담관 협착 1예
송대근ㆍ방제소ㆍ박원형ㆍ김태균ㆍ박현경ㆍ민보영ㆍ양수현ㆍ변종훈
서울보훈병원 소화기내과
Pancreatic and Biliary Strictures Associated with Cholangitis and Bile Reflux Following Endoscopic Papillectomy of Ampullary Adenoma
Dae-Geun Song, M.D., Jei So Bang, M.D., Won Hyeong Park, M.D., Tae Gyoon Kim, M.D., Hyun Gyung Park, M.D., Bo Young Min, M.D., Su Hyun Yang, M.D. and Jong Hoon Byun, M.D.
Department of Internal Medicine, Seoul Veterans Hospital, Seoul, Korea
Abstract
Ampullary adenoma is rare but clinically important because it is a premalignant lesion. Use of endoscopic gastroduodenoscopy has increased detection of adenoma of the major duodenal papilla. Endoscopic papillectomy is a promising technique to supplant surgical ampullectomy, because it is less aggressive and more stable. However, various complications include bleeding, perforation, pancreatitis and cholangitis. We describe pancreatic and biliary strictures associated with cholangitis, and bile reflux through the pancreatic duct to the minor duodenal papilla after endoscopic papillectomy. Pancreatic and biliary strictures have not been hitherto reported complications. We performed endoscopic papillary balloon dilatation, minor papilla papillotomy and inserted a drain tube through the accessory pancreatic duct. (Korean J Gastrointest Endosc 2009;39: 50-54)
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