title: [An extremely elderly patient with choledocholithiasis and many complications].
abstract: It was very difficult to treat a 90-year-old woman for choledocholithiasis with acute obstructive suppurative cholangitis, gallbladder perforation, and a pool of bile in the right perirenal spase. Extracorporeal shockwave lithotripsy (ESWL) was performed after emergency percutaneous transhepatic biliary drainage (PTBD), but we could not perform lithotripsy successfully because of large and hard stones. Although Endoscopic sphincterotomy (EST) was performed using an ultratome by rendezvous method. Lithotripsy was finally successful, after three times endoscopic mechanical lithotripsy (EML) and procedure using an endotriptor for basket impaction. It is very important in advanced aged patients that endoscopic treatment should be performed step by step.
authors.affiliation: Department of Internal Medicine, Takagi Hospital.
authors.forename: K
authors.initials: K
authors.lastname: Nishida
authors.forename: S
authors.initials: S
authors.lastname: Kawazoe
authors.forename: M
authors.initials: M
authors.lastname: Higashijima
authors.forename: K
authors.initials: K
authors.lastname: Takagi
authors.forename: R
authors.initials: R
authors.lastname: Akashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D042882:Gallstones / Q000628:therapy*; D006801:Humans; D008096:Lithotripsy