총담관 담석이 의심되는 환자의 평가

Abstract

총담관 담석은 담도 질환 중 가장 흔한 질환 중의 하나이다.우선적으로 간기능 혈액 검사와 복부 초음파를 시행하여총담관 담석의 위험도를 분류한 후, 중간위험도의 총담관 담석환자는 EUS 혹은 MRCP를 시행하는 것을 권장한다. 향후 환자상태에 따라 어떤 검사가 더 효율적으로 총담관 담석의 진단에도움이 될지 전향적인 대규모 연구가 필요할 것이다.

Common bile duct stones (CBDS) are estimated to be present in 10–20% of individuals with symptomatic gallstones. Most patients with gallstones remain asymptomatic throughout their lifetime, but 10–25% of them may develop biliary pain or complications including pain, jaundice, infection and acute pancreatitis, with an annual risk of about 2–3% for symptomatic disease and 1–2% for major complications. The primary treatment, endoscopic retrograde cholangio-pacreatography (ERCP), is minimally invasive but associated with adverse events in 6% to 15% of patients. Therefore, exact evaluation of CBDS is important in patients with gallstones. Clinicians are therefore confronted with a number of potentially valid options such as endoscopic ultrasonography versus magnetic retrograde cholangiopancreatography in order to diagnose suspected CBDS. The aim of this review for evaluation of patients suspected of common bile duct stone is to provide practical advice on how to manage patients with CBDS. It considers diagnostic strategies in patients with suspected CBDS, as well as the different therapeutic options available for CBDS.