|
|
 |
Ramsar-Northern Iran, Autumnal view of the foggy Jungle
(photo by M.H.Azizi MD, November 2011)
|
|
|
|
|
|
|
|
|
Archives of Iranian Medicine: 2011 and beyond
AIM will be published monthly from 2012 with an increased focus on preventive medicine and public health. In its 14th birthday, this switch from bimonthly publication, will complete the Journal’s 4-year transition from a quarterly journal. This change will not only allow us to present the recent advances in medical sciences in a more timely fashion to our readers, but also shorten the wait time for the authors, and has been made possible with the constant support and enthusiasm of our contributors and reviewers. More...
|
|
|
|
|
|
|
|
|
A Monthly Peer-Reviewed Medical Journal Published by the Academy of Medical Sciences of the I.R. Iran; Indexed in PubMed/MEDLINE, ISI Web of Science, EMBASE, SCOPUS, CINHAL, PASCAL, CSA, SID, ISSN: Print 1029-2977, Online 1735-3947.
|
|
|
|
Call for Papers
The Achieves of Iranian Medicine is planning to publish a series of special issues on liver disease. The topics include, but are not limited to, viral hepatitis (A through E), fatty liver and steatohepatitis, cirrhosis, and liver transplantation.
Hereby we invite you to submit any original research paper on liver disease by emailing to merat@tums.ac.ir. Depending on the papers we receive, we are planning to publish the first special issue by June 2012.
Shahin Merat, MD
Guest editor,
Reza Malekzadeh
Editor in chief
Hossein Poustchi, MD
Guest editor,
|
| |
|
|
|
Assessment and Treatment of Choledocholithiasis when Endoscopic Sphincterotomy is not Successful
|
Download PDF Fulltext
|
|
Authors:
Abolfazl Shojaiefard1, Majid Esmaeilzadeh2, *Zhamak Khorgami3, Rasoul Sotoudehmanesh4, Ali Ghafouri5, |
|
Authors’ Affiliations: 1,3,5Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran, 4Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Germany, 3Digestive Diseases Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran .
•Corresponding author and reprints: Zhamak Khorgami MD, Department of Surgery, Tehran University of Medical Sciences, Shariati Hospital, Kargar Ave, Tehran, Iran. Tel.: +98-21-84902450, Fax: +98-21-88633039, E-mail: khorgami@gmail.com.
Accepted for publication: 21 October 2011
|
|
Keywords:
Choledochoduodenostomy, Choledochojejunostomy, Choledocholithiasis, ERCP
|
|
BACKGROUND: Choledocholithiasis exists in approximately 15% of patients with gallstones and is present in 3%-10% of those undergoing cholecystectomy.
METHODS: In this study, we retrospectively analyzed the outcome patients with choledocholithiasis that were managed by open common bile duct (CBD) exploration according to our center's protocol. Endoscopic retrograde cholangiopancreatography (ERCP) was performed for CBD stone clearance. If ERCP and sphincterotomy were not successful, open surgical exploration of CBD was performed with T-tube insertion without routine intraoperative cholangiography (IOC).
RESULTS: We studied 1462 patients with choledocholithiasis. ERCP was successful in in 1276 (87.2%) patients. A total of 186 (12.8%) underwent surgery. Of these, 82 (45.2%) had CBD exploration and T-tube insertion without IOC. Choledochoduodenostomy was performed in 82 (44.1%) patients and choledochojejunostomy was performed in 20 (10.8%). Retained stones were found only in 4 cases which were treated by ERCP.
CONCLUSION: ERCP is successful in most cases with choledocholithiasis. If ERCP fails, open exploration of CBD and T-tube insertion, or biliary-enteric anastomosis are acceptable ways for CBD drainage. The rate of retained stone is not more than expected, thus elective IOC is more acceptable than routine IOC. Routine IOC is time-consuming and particularly difficult in elderly patients and emergency conditions.
|
|
|
|
ISSN:1029-2977
Article type:Original
|
|
| |
|
|