Preferred Treatment for choledocholithiasis (ERCP)

Etiology of choledocholithiasis, the main causes of formation of choledocholithiasis are inherited abnormal cholesterol metabolism, cholestasis and infection of the biliary system.

Bad living habits can increase its incidence, such as people who often eat hot pot, barbecue, egg yolk, animal offal and other greasy food; Often do not eat breakfast, hungry a full meal, eating irregular people.

Clinical manifestations and hazards of choledocholithiasis. The most typical clinical manifestations of choledocholithiasis are epigastral colic and back pain, chills, high fever and subsequent jaundice. If the lower end of the choledocholithiasis is completely obstructed, it can be manifested as swollen and tender cystic mass in the right upper abdomen. The liver will also appear symmetrical, diffuse swelling, tenderness; The patient presents with high fever, which can lead to a series of toxic symptoms such as liver cell damage and cholestasis. If the patient is not seen in time, or is seen late, the infection will be further aggravated, with systemic toxemia and toxic shock symptoms, which can be life-threatening in severe cases.

Why choose ERCP for choledocholithiasis? ERCP is a retrograde cholangiopancreatography technique in which contrast agent is injected into the duodenal papilla under an endoscope. It can be used for both the diagnosis and treatment of bile duct calculi. With the continuous development of endoscopic equipment and technology, ERCP combined with laparoscopic cholecystectomy has been widely recognized for the treatment of bile duct calculi, which has replaced open surgery to some extent and become the first choice for the treatment of extrhepatic bile duct calculi. Open lithotomy is a classic and standard method for the clinical treatment of choledocholithiasis, but this operation is characterized by high trauma and slow postoperative recovery. With the wide application of ERCP in clinical practice, it has gained the favor of patients and doctors. This operation has the advantages of less trauma, short course of disease, good efficacy and fewer complications. Choledocholithiasis with or without symptoms should be treated with ERCP to avoid cholangitis such as fever, abdominal pain, and jaundice. Without surgery, some patients may develop biliary pancreatitis. There are bile duct stones prone to recurrence, such as recurrent stones can also choose ERCP stone, and the difficulty of laparotomy again surgery is relatively large.

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