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HOME > Kosin Med J > Volume 31(2); 2016 > Article
Case Report
Endoscopic Removal of Remained Drawstring After Percutaneous Transhepatic Biliary Drainage
Tae Wook Yoon, Geun Yong Jung, Young Jun Park, Jun Young Choi, Jee Hwan Jung, Tae Gyoon Kim
Kosin Medical Journal 2016;31(2):173-178.
DOI: https://doi.org/10.7180/kmj.2016.31.2.173
Published online: January 20, 2016

Department of Internal Medicine, VHM Medical center, Seoul, Korea

Corresponding Author: Tae Gyoon Kim, Department of Internal Medicine, VHM Medical center, 53, Jihwangdo-ro 61-gil, Gangdong-gu, Seoul 05368, Korea Tel: +82-2-2225-1114 Fax: +82-2-2225-4374 Email: gyoondle@hanmail.net
• Received: June 23, 2015   • Accepted: September 16, 2015

Copyright © 2016 Kosin University School of Medicine Proceedings

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • The percutaneous transhepatic biliary drainage (PTBD) is an effective intervention as a palliative therapy for relieving a jaundice and cholangitis. It may be used in place of Endoscopic retrograde cholangiopancreatography (ERCP) in the obstructive biliary disease. Recently, by developing invasive procedures, the incidence of the complications such as bleeding and perforation has been increasing in the diagnosis and treatment of hepatobiliary disease. We report here on a case of remained drawstring after PTBD in a 85-year-old man. The patient was conducted PTBD for relieving a jaundice and cholangitis. And then the patient had complained of abdominal pain constantly. A few days later, we removed PTBD and attempted ERCP for removal of CBD stone. The ERCP showed remained drawstring around ampulla of vater and we removed it by IT knife. The drawstring was successfully removed.
Fig. 1.
Black arrow in abdomen CT demonstrating 9mm sized biliary stone in the distal common bile duct.
kmj-31-173f1.jpg
Fig. 2–1.
Endoscopy showed an ampulla of vater tightened by a remained drawstring after removing percutaneous transhepatic biliary drainage. Fig. 2–2. Endoscopy showed an ampulla of vater after removing a remained drawstring. Fig. 2–3. The remained drawstring to prevent a drainage tube from falling into the body.
kmj-31-173f2.jpg
Fig. 3.
The twisted biliary tube on the duodenum.
kmj-31-173f3.jpg
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        Endoscopic Removal of Remained Drawstring After Percutaneous Transhepatic Biliary Drainage
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