CBD结石肝硬化难以控制出血

                               
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Common bile duct stones in a patient with cirrhosis. CBD cannulation was difficult. The pancreatic duct was cannulated in the long scope position. A transpancreatic precut (Goff precut) was performed. A pancreatic stent also facilitated eventual CBD cannulation. The stones were removed but there was significant bleeding. A covered metal biliary stent was placed to stop the bleeding. In cirrhotic patients, bleeding from sphincterotomy can be very severe or even fatal. Covered metal stents are typically very effective to stop bleeding from sphincterotomy.