Outcome of Digital Cholangioscopy and Laser Lithotripsy for Impacted Biliary Stones

IF 0.4 Q4 GASTROENTEROLOGY & HEPATOLOGY
Vikas Singla, A. Arora, Sawan Bopanna, Shivam Khare, Ashish Kumar, N. Bansal, Praveen Sharma
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Abstract

Background and Aims Impacted stones in the bile duct are difficult to extract, and are predictor of failure of conventional endoscopic retrograde cholangiopancreatography techniques including mechanical lithotripsy and large balloon dilatation. Intracorporeal lithotripsy may be an effective technique for these stones. The aim of this study is to report the efficacy and safety of intracorporeal laser lithotripsy for impacted stones in the bile duct. Method This study is retrospective analysis of prospectively collected data. Patients with impacted stones in the bile duct underwent cholangioscopy with spyglass DS system and laser lithotripsy. Outcome measures were proportion of patients with complete clearance of bile duct after the first session, number of sessions required for complete clearance, and the complications. Results Forty-three patients (27 female) with mean age of 56.12 ± 15.16 years underwent digital cholangioscopy and laser lithotripsy. Mean bilirubin value was 1.8 ± 1.6 mg/dL, 20 (46.51%) patients had single stone, 35(81.39%) patients had only bile duct stones, and 8(18.61%) patients had additional stones in cystic duct or intrahepatic biliary radical. Mean size of largest stone was 16.2 ± 4.4mm. Average duration of the procedure was 69.11 ± 28.12minutes, and complete clearance was achieved in 41/43 (95.34%) patients after the first session. Mean number of sessions required for complete clearance was 1.02 ± .26. Postprocedure cholangitis occurred in one patient. Conclusion Intracorporeal laser lithotripsy is an effective and safe modality for the clearance of impacted bile duct stones.
数字胆道镜联合激光碎石治疗阻生胆结石的疗效
背景和目的胆管内阻生结石难以取出,是常规内镜逆行胆管造影技术(包括机械碎石和大球囊扩张)失败的预测因素。体内碎石术可能是治疗此类结石的有效方法。本研究的目的是报告体内激光碎石术治疗胆管内结石的有效性和安全性。方法对前瞻性收集的资料进行回顾性分析。胆管内阻生结石患者行望远镜DS系统胆道镜及激光碎石术。结果测量是第一次治疗后胆管完全通畅的患者比例、完全通畅所需的治疗次数和并发症。结果43例患者行数字胆道镜及激光碎石术,其中女性27例,平均年龄56.12±15.16岁。平均胆红素值为1.8±1.6 mg/dL,单发结石20例(46.51%),单发胆管结石35例(81.39%),胆囊管或肝内胆道结石8例(18.61%)。最大结石的平均尺寸为16.2±4.4mm。手术平均持续时间为69.11±28.12分钟,41/43(95.34%)患者在第一次治疗后完全清除。完全清除所需的平均疗程数为1.02±0.26。术后胆管炎1例。结论体内激光碎石术是一种安全有效的胆管结石清除方法。
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来源期刊
Journal of Digestive Endoscopy
Journal of Digestive Endoscopy GASTROENTEROLOGY & HEPATOLOGY-
自引率
28.60%
发文量
35
审稿时长
22 weeks
期刊介绍: The Journal of Digestive Endoscopy (JDE) is the official publication of the Society of Gastrointestinal Endoscopy of India that has over 1500 members. The society comprises of several key clinicians in this field from different parts of the country and has key international speakers in its advisory board. JDE is a double-blinded peer-reviewed, print and online journal publishing quarterly. It focuses on original investigations, reviews, case reports and clinical images as well as key investigations including but not limited to cholangiopancreatography, fluoroscopy, capsule endoscopy etc.
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