Laser Lithotripsy: Measurement of Pressure and Shockwaves in Stones

AbstractEndoscopic retrograde cholangiopancreatography (ERCP) is the current treatment of choice in bile duct stones. Several factors such as variant anatomy of ampulla and surgical procedures like hepaticojejunostomy limit the success of ERCP in treating bile duct stones. Percutaneous transhepatic laser lithotripsy using interventional radiologic and endourologic techniques, which is uncommon, is a reasonable treatment option in such difficult cases. It is a minimally invasive, safe procedure accompanied by a high success rate, minimal morbidity, and a short hospital stay. We report our technique and experience in a series of three patients who underwent percutaneous transhepatic biliary drainage (PTBD) followed by percutaneous transhepatic laser lithotripsy in an attempt to avoid open surgery when ERCP was technically difficult.

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MP80-12 COST ANALYSIS OF URETERAL STENTING AFTER UNCOMPLICATED URETEROSCOPIC LASER LITHOTRIPSY FOR UROLITHIASIS: A DECISION MODEL ANALYSIS

The Journal of Urology ◽

10.1016/j.juro.2015.02.2848 ◽

2015 ◽

Vol 193 (4S) ◽

Cited By ~ 1

Author(s):

Hin Yu Vincent Tu ◽

Edward Matsumoto

Keyword(s):

Cost Analysis ◽

Decision Model ◽

Model Analysis ◽

Laser Lithotripsy ◽

Ureteral Stenting

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Prognostic Factors for the Outcome of Salivary Gland Holmium: YAG Laser Intraductal Lithotripsy

Ear Nose & Throat Journal ◽

10.1177/01455613211010075 ◽

2021 ◽

pp. 014556132110100

Author(s):

Shuo-Jen Wang ◽

Lung-Che Chen ◽

Yi-Chih Lin ◽

Yen-Chun Chen ◽

Luong Huu Dang ◽

...

Keyword(s):

Logistic Regression ◽

Salivary Gland ◽

Success Rate ◽

Operative Time ◽

Tertiary Care ◽

Operation Time ◽

Laser Lithotripsy ◽

Successful Outcome ◽

Care Hospital ◽

Yag Laser

Objectives: Holmium: YAG laser has gained its popularity throughout the years and is used to treat sialolithiasis, which helps to overcome the limitations of traditional sialendoscopic lithotripsy for larger-sized salivary stones. However, little information is available regarding factors predicting the success rate of Holmium: YAG laser intraductal lithotripsy. The purpose of this study is to investigate the factors affecting the success rates of Holmium: YAG laser lithotripsy for salivary stones treatment in a tertiary care hospital. Methods: A retrospective study conducted in patients receiving sialolithiasis surgery under sialendoscopy from May 2013 to March 2015 at Mackay Memorial Hospital, Taiwan. Data on various factors, including patients’ age, gender, glands, size of largest stone, multiple stones (≥2 stones), location of the stone (distal duct, middle duct, proximal duct, and hilum), and operative time. The success of the surgery defined as patients without any complaints such as swelling or tenderness. Logistic regression and Fisher exact tests were employed to examine these factors on the success rate. Results: Fifty-four patients who received sialendoscopy surgery with a mean age of 35.74 years old recruited. Logistic regression identified the operation time exceeding 210 minutes showed 23.497 folds higher odd ratio of having a result of operation failure ( P < .05). Conclusion: The prolonged operation time is the sole independent factor affecting the successful outcome for salivary gland intraductal laser lithotripsy. We recommend operative time be no more than 210 minutes to increase the success rate in salivary gland Holmium: YAG laser intraductal lithotripsy.

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Single-use duodenoscope in the management of an elderly patient with difficult bile duct stones: laser lithotripsy using a disposable cholangioscope

VideoGIE ◽

10.1016/j.vgie.2021.03.005 ◽

2021 ◽

Author(s):

D. Nageshwar Reddy ◽

Mohan Ramchandani ◽

Sundeep Lakhtakia ◽

Pradev Inavolu ◽

Harsh Vardhan Tevethia

Keyword(s):

Elderly Patient ◽

Bile Duct ◽

Laser Lithotripsy ◽

Bile Duct Stones ◽

Single Use

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Assessing the Role of Light Absorption in Laser Lithotripsy by Isotopic Substitution of Kidney Stone Materials

ACS Biomaterials Science & Engineering ◽

10.1021/acsbiomaterials.0c00790 ◽

2020 ◽

Vol 6 (9) ◽

pp. 5274-5280

Author(s):

Sorout Shalini ◽

Derek S. Frank ◽

Ali H. Aldoukhi ◽

Sami E. Majdalany ◽

William W. Roberts ◽

...

Keyword(s):

Light Absorption ◽

Kidney Stone ◽

Laser Lithotripsy ◽

Isotopic Substitution ◽

Stone Materials ◽

Role Of Light

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Effects of irrigation fluid temperature during flexible ureteroscopic holmium laser lithotripsy on postoperative fever and shivering: a randomized controlled trial

BMC Urology ◽

10.1186/s12894-021-00841-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yue He ◽

You-Gang Feng ◽

Jun He ◽

Bo Liang ◽

Ming-Dong Jiang ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Laser Lithotripsy ◽

Holmium Laser ◽

Fluid Temperature ◽

Postoperative Fever ◽

Irrigation Fluid ◽

Suspected Infection ◽

Randomized Controlled ◽

Holmium Laser Lithotripsy

Abstract Background Flexible ureteroscopic holmium laser lithotripsy is used to treat urinary tract calculi, but postoperative complications include shivering, fever and infection. To investigate the effects of irrigation fluid temperature on postoperative complications. Methods This randomized controlled trial included 120 consecutive patients undergoing flexible ureteroscopic holmium laser lithotripsy at the Urology Department, Suining Central Hospital, Sichuan, China between January 2017 and July 2019. Patients were randomized 1:1:1 into three groups (17 °C, 27 °C or 37 °C). Primary outcome was fever incidence (body temperature > 37.5 °C) within 48 h after surgery. Secondary outcomes included shivering incidence during recovery from anesthesia, white blood cell count (WBC), serum procalcitonin (PCT) and incidence of suspected infection (temperature > 38.5 °C and PCT > 0.5 µg/L). Results There were 108 patients, (17 °C group, n = 36; 27 °C group, n = 35; 37 °C group, n = 37), received flexible ureteroscopic holmium laser lithotripsy and analyzed. Age, gender distribution, body mass index, ASA grade, stone burden, preoperative creatinine, preoperative core temperature and irrigation fluid volume did not differ significantly between groups. 17 °C, 27 °C and 37 °C groups exhibited significant differences in the incidences of postoperative fever (38.9% vs. 17.1% vs. 13.5%) and shivering (22.2% vs. 5.7% vs. 2.7%) (p < 0.05 for all pairwise comparisons). There was no significant difference of WBC, PCT and incidence of suspected infection in 37 °C or 27 °C group compared with 17 °C group. One case each of flash pulmonary edema and bleeding occurred in 37 °C group. Conclusion Warming the irrigation fluid can reduce the incidence of postoperative fever and shivering, but further studies are needed to determine the optimal temperature. Trial registration The trial was registered at the Chinese Clinical Trials Registry and allocated as ChiCTR2000031683. The trial was registered on 07/04/2020 and this was a retrospective registration.

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