scholarly journals CHOLANGIOSCOPY IN BILE DUCT DISEASE: a case series

2014 ◽  
Vol 51 (3) ◽  
pp. 250-254 ◽  
Author(s):  
Eduardo Guimarães Hourneaux de MOURA ◽  
Tomazo FRANZINI ◽  
Renata Nobre MOURA ◽  
Fred Olavo Aragão Andrade CARNEIRO ◽  
Everson Luiz de Almeida ARTIFON ◽  
...  

Context Direct endoscopic visualization of biliopancreatic duct is certainly one of the greatest advances of therapeutic endoscopy. The use of a single-operator cholangioscopy platform (SpyGlass) is a promising technique in the evaluation of diseases such as indeterminate biliary stricture and giant choledocholitiasis. This is the first Brazilian case series using this technology. Methods We report a case series of 20 patients in whom SpyGlass was used with diagnostic and therapeutic intention. Results Most patients were female (60%) and the median age was 48 years (ranging from 14 to 94). Choledocholitiasis was the most common indication (12/20), and electrohydraulic lithotripsy was applied in eight (66%). Electrohydraulic lithotripsy was successful in seven (87.5%) patients. Partial stone fragmentation occurred in one patient with large stone causing stone-choledochal disproportion, which was conducted with biliary plastic stent placement and a second scheduled endoscopic approach in 3 months. In cases of undefined etiology of biliary strictures, it was possible to exclude malignancy due to direct visualization (7/8) or biopsy (1/8). One complication occurred (duodenal perforation) after papillary balloon dilation. Conclusion The use of SpyGlass demonstrated the benefits, especially in cases of large bile duct stones and indeterminate biliary strictures. Other potencial improvements such as reduction on radiation exposure should be confirmed in prospective studies.

Medicina ◽  
2022 ◽  
Vol 58 (1) ◽  
pp. 120
Author(s):  
Edoardo Troncone ◽  
Michelangela Mossa ◽  
Pasquale De Vico ◽  
Giovanni Monteleone ◽  
Giovanna Del Vecchio Blanco

Biliary stones represent the most common indication for therapeutic endoscopic retrograde cholangiopancreatography. Many cases are successfully managed with biliary sphincterotomy and stone extraction with balloon or basket catheters. However, more complex conditions secondary to the specific features of stones, the biliary tract, or patient’s needs could make the stone extraction with the standard techniques difficult. Traditionally, mechanical lithotripsy with baskets has been reported as a safe and effective technique to achieve stone clearance. More recently, the increasing use of endoscopic papillary large balloon dilation and the diffusion of single-operator cholangioscopy with laser or electrohydraulic lithotripsy have brought new, safe, and effective therapeutic possibilities to the management of such challenging cases. We here summarize the available evidence about the endoscopic management of difficult common bile duct stones and discuss current indications of different lithotripsy techniques.


2014 ◽  
Vol 59 (6) ◽  
pp. 1302-1306 ◽  
Author(s):  
Jong Chan Lee ◽  
Jong Ho Moon ◽  
Hyun Jong Choi ◽  
Dong Choon Kim ◽  
Moon Han Choi ◽  
...  

2018 ◽  
Vol 8 (2) ◽  
Author(s):  

Tóm tắt Đặt vấn đề: Sỏi đường mật chính thường gặp là ống mật chủ (OMC) là bệnh lý phổ biến ở Việt Nam. Phẫu thuật nội soi (PTSN) để lấy sỏi qua OMC ngày càng được áp dụng rộng rãi trong điều trị bệnh sỏi mật. Kết hợp tán sỏi qua nội soi đường mật trong lúc phẫu thuật nhằm làm sạch sỏi đặc biệt là sỏi trên gan đang được áp dụng ở nhiều cơ sở. Phương pháp nghiên cứu: Nghiên cứu kết quả ứng dụng PTNS và nội soi tán sỏi qua OMC để điều trị sỏi đường mật chính tại bệnh viện VN-TĐ Uông Bí. Phương pháp can thiệp lâm sàng, mô tả tiến cứu. Đối tượng nghiên cứu là những người bệnh có sỏi đường mật chính (sỏi đường mật trong gan và ngoài gan) được PTNS ổ bụng lấy sỏi đường mật qua OMC có kết hợp tán sỏi điện thủy lực được thực hiện tại bệnh viện VN-TĐ Uông Bí từ 9/2014-9/2017. Thông tin của người bệnh được thu thập trước và sau phẫu thuật, xử lý bằng phần mềm thống kê y học SPSS 16.1. Kết quả: Gồm 31 trường hợp (TH) được nghiên cứu, có 9 nam và 22 nữ, tuổi trung bình là 55,45 ± 15,05. Trong đó sỏi OMC đồng thời với sỏi trong gan là 31, sỏi túi mật kết hợp 9 TH. 21 TH lấy hết sỏi đường mật ngay trong phẫu thuật. 10 người bệnh còn sót sỏi trong gan phải lấy sỏi qua đường hầm Kehr sau 1 tháng. 1 người bệnh phải chuyển mổ mở, 2 người bệnh bị rò mật sau mổ. Thời gian phẫu thuật trung bình là 130.65 ± 46.91 phút, thời gian nằm viện trung bình là 8,58 ± 3,59 ngày. Không có tử vong do phẫu thuật. Kết luận: Đây là những kinh nghiệm PTNS mở OMC có kết hợp với nội soi tán sỏi để điều trị sỏi đường mật đầu tiên của chúng tôi. Chúng tôi nhận thấy phẫu thuật có tính khả thi an toàn cũng như hiệu quả tại bệnh viện VN-TĐ Uông Bí. Abstract Introduction: Common bile duct (CBD) stone is endemic in Vietnam. Laparoscopic common bile duct exploration (LCBDE) has gained wide popularity in the treatment of choledocholithiasis. At the same time, electrohydraulic lithotripsy (EHL) via choledochoscopy might help to clear intrahepatic stones. Material and Methods: The aim of this study is to access the results of laparoscopic common bile duct exploration associating with electrohydraulic lithotripsy via choledochoscopy to clear biliary stones Vietnam – Thuy Dien – Uong Bi Hospital. This is a prospective, interventional and descriptive case series study. Patients with both extra-and intra-hepatic stones who underwent laparoscopic common bile duct exploration (LCBDE) from September 2014 to September 2017 were enrolled in our study. The data was prospectively collected and analysed by using SPSS 16.1. Results: There were 9 men and 22 women with age ranging from 12 to 78 years old (average 55,45 ± 3,59). There were 9 patients with gallbladder stones. Complete bile duct clearance was done in 21 patients. 10 patients with residual intrahepatic stones required extracting stones through T tube tunnel by choledochoscopy and EHL. The average duration of surgery was 130.65 ± 46.91 minutes and the average hospital stay was 8,55 ± 3,59 days. There were one conversion to open surgery and two cases of bile leakage. We had non-fatal postoperative complications. Conclusion: This is preliminary experience of LCBDE in my hospital in the management of choledocholithiasis. It should be considered effective and feasible in the treatment of CBD stones in Vietnam – Thuy Dien – Uong Bi Hospital. Keyword: Laparoscopic common bile duct exploration, Electrohydraulic lithotripsy via choledochoscopy


2013 ◽  
Vol 21 (6) ◽  
pp. 405-409 ◽  
Author(s):  
Toshio Fujisawa ◽  
Koichi Kagawa ◽  
Kantaro Hisatomi ◽  
Kensuke Kubota ◽  
Atsushi Nakajima ◽  
...  

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