Percutaneous Transhepatic Flexible Ureteroscope-Guided Frequency-Doubled Dual Pulse ND:YAG Laser Lithotripsy for Refractory Choledocholithiasis

2020 ◽  
Author(s):  
Wei Wang ◽  
Wujie Wang ◽  
Shilin Tian ◽  
Chunchun Shao ◽  
Yunming Jia ◽  
...  
Keyword(s):  
Nd:Yag Laser ◽  
Laser Lithotripsy ◽  
Flexible Ureteroscope

scholarly journals Percutaneous Transhepatic Flexible Ureteroscope-Guided Frequency-Doubled Dual Pulse ND:YAG Laser Lithotripsy for Refractory Choledocholithiasis

2021 ◽  
Author(s):  
Wei Wang ◽  
Wujie Wang ◽  
Yunming Jia ◽  
Chao Chen ◽  
Shilin Tian ◽  
...  
Keyword(s):  
Bile Duct ◽  
Nd:Yag Laser ◽  
Thermal Damage ◽  
Clinical Success ◽  
Clinical Success Rate ◽  
Laser Lithotripsy ◽  
Gelatin Sponge ◽  
Laser Safety ◽  
Flexible Ureteroscope ◽  
The Mean

Abstract ObjectivesTo evaluate the safety and efficiency of percutaneous transhepatic flexible ureteroscope-guided frequency-doubled dual pulse ND:YAG laser lithotripsy (PTFU-FREDDY) for refractory choledocholithiasis.MethodsFrom December 2017 to October 2018, 24 refractory choledocholithiasis patients with large common bile duct stones, anatomic variations, multiple stones or stones at difficult locations (impacted, above a biliary stricture) were admitted to two centers. Four patients were considered intolerant to surgery or endoscopic retrograde cholangiopancreatography (ERCP), and 2 had ERCP failure, the others refused. All patients underwent PTFU-FREDDY. Clinical success rate, recurrence of calculus, laser safety, and related complications, such as fever, haematoma, and local thermal damage were recorded. ResultsPatients’ mean age was 66.0±12.1 (43-89) years. Sex ratio was 1:1.2 (male: female). The mean diameter of stones was 21.8±2.4 mm. All stones were successfully broken and pushed into the duodenum. The mean lithotripsy frequency and procedure time of Bilirubin stones was higher than cholesterol stones, and the mixed were in middle，P<0.01. One patient（4.2%）had haemobilia, requiring immediate transarterial embolisation with 100mg 300-500um gelatin sponge particles. No pancreatitis, sepsis, or serious local thermal damage, such as bile duct perforation, was observed. The rates of Grade A/B of fever, abdominal pain, nausea, and vomiting were 12.5%, 12.5%, 8.3%, and 4.2% during follow-up, respectively. The recurrence was none at the endpoint of 12 months.Conclusion PTFU-FREDDY is a safe and effective alternative treatment for refractory choledocholithiasis, especially when traditional treatments fail or are difficult to perform.

Refractory choledocholithiasis treated with combination of ERCP and percutaneous biliary laser lithotripsy with flexible ureteroscope

2015 ◽  
Vol 82 (4) ◽  
pp. 758-760
Author(s):  
Himanshu Verma ◽  
Kai Hammerich ◽  
Jessica Mandeville ◽  
Sebastian Flacke ◽  
Mark Sterling
Keyword(s):  
Laser Lithotripsy ◽  
Flexible Ureteroscope

Primary Results in the Laser Lithotripsy Using a Frequency Doubled Q-Switched Nd:YAG Laser

1988 ◽  
pp. 49-52
Author(s):  
K. Dörschel ◽  
H-P. Berlien ◽  
T. Brodzinski ◽  
J. Helfmann ◽  
G. Müller ◽  
...  
Keyword(s):  
Nd:Yag Laser ◽  
Laser Lithotripsy

An Encrusted Ureteral Stent Removed by Open Surgery in a Solitary Pelvic Ectopic Kidney (PEK) Patient Presented with Anuria and Renal Dysfunction: A Case Report

2020 ◽  
Author(s):  
Yang Pan ◽  
Gang Chen ◽  
Han Chen ◽  
Yunxiao Zhu ◽  
Hualin Chen
Keyword(s):  
Computed Tomography ◽  
Shock Wave ◽  
Ureteral Obstruction ◽  
Open Surgery ◽  
Shock Wave Lithotripsy ◽  
Laser Lithotripsy ◽  
Ureteral Stent ◽  
Ectopic Kidney ◽  
Flexible Ureteroscope

AbstractA 19-year-old man complaining of anuria for 1 day was presented. A ureteral stent was indwelled 3 months ago for preventing ureteral obstruction and protecting kidney function. Abdominopelvic computed tomography (CT) scan revealed a solitary pelvic ectopic kidney (PEK) and severe hydronephrosis. And the ureteral stent was covered by encrustations which caused ureteral obstruction. The stent had been retained in his ureter for more than 3 months until he was admitted. It couldn’t be removed after shock wave lithotripsy (SWL) or flexible ureteroscope laser lithotripsy (f-URS). Finally, we had to conduct open surgery which was an alternative option. The stent was replaced by a new one successfully. The patient was discharged safely without postoperative complications. After 2 months of follow-up, the patient’s renal function remained stable.

scholarly journals Spotlight — Management of pyelovesical bypass device stones

2018 ◽  
Vol 12 (5) ◽  
pp. E267-8
Author(s):  
Ahmad Almarzouq ◽  
Sero Andonian
Keyword(s):  
Endometrial Stromal Sarcoma ◽  
Laser Lithotripsy ◽  
Holmium Laser ◽  
Pelvic Surgery ◽  
Flexible Ureteroscopy ◽  
Stromal Sarcoma ◽  
Holmium Laser Lithotripsy ◽  
Flexible Ureteroscope ◽  
Suppressive Antibiotic Therapy ◽  
Tract Infections

Pyelovesical bypass devices or artificial ureters have been described as a last resort in patients with long ureteral strictures that fail traditional endoscopic and open repair. Herein, we describe a 52-year-old female who had a Detour (Coloplast, Humlebaek, Denmark) pyelovesical bypass device inserted after an iatrogenic ischemic injury to the distal two-thirds of the left ureter during pelvic surgery for recurrent endometrial stromal sarcoma. Six months after placement of the device, she presented with gross hematuria and recurrent urinary tract infections (UTIs) and was found to have encrustation of the distal silicone tip of the Detour device within the bladder. This was managed with resection of the distal silicone tip and flexible ureteroscopy with holmium laser lithotripsy. Despite suppressive antibiotic therapy and medical therapy for hypercalciuria, she presented four years later with intraluminal encrustations in the proximal end of the device. This was successfully managed with flexible ureteroscopy with holmium laser lithotripsy. Therefore, this case illustrates the feasibility of flexible ureteroscopy and holmium laser lithotripsy of Detour device encrustations as long as the device is not kinked and it allows the passage of the flexible ureteroscope up to the calcifications. In addition, patients contemplating insertion of such devices should be counselled regarding the risk of recurrent infections and encrustations.

scholarly journals Laser Lithotripsy — The New Wave

1990 ◽  
Vol 4 (9) ◽  
pp. 632-636 ◽  
Author(s):  
J Hochberger ◽  
C Ell
Keyword(s):  
Shock Wave ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Tissue Damage ◽  
Nd:Yag Laser ◽  
Laser Lithotripsy ◽  
Endoscopic Retrograde ◽  
Endoscopic Papillotomy ◽  
Nanosecond Pulses ◽  
Extracorporeal Shock Wave

Currently more than 90% of all common bile duct concrements can he removed via the endoscopic retrograde route by means of endoscopic papillotomy, stone extraction by baskets and balloon catheters, or mechanical lithotripsy. Oversized, very hard or impacted stones however often st ill resist conventional endoscopic therapy. Laser lithotripsy represents a promising new endoscopic approach to the nonsurgical treatment of those common bile duct stones. Currently only short-pulsed laser systems with high power peaks but low potential for thermal tissue damage are used for stone fragmentation. Systems in clinical applications are the pulsed free-running-mode neodymium YAG (Nd:YAG) laser (1064 nm, 2 ms) and the dye laser (504 nm, 1 to 1.5 μs). Energy transmission via highly flexible 200 ìm quartz fibres allows an endoscopic retrograde approach to the stone via conventional duodenoscope or mother-baby-scope systems. New systems currently in preclinical and first clinical testing are the Q-switched Nd:YAG laser (1064 nm, 20 ns) and the Alexandrite laser (700 to 815 nm, 30 to 500 ns). By means of extremely short nanosecond pulses (10-9s) for the induction of local shock waves at the stone surface, possible tissue damage is even more reduced. No complications have been reported so far after applying laser lithotripsy clinically in about 120 patients worldwide. Compared to extracorporeal shock wave treatment, laser lithotripsy can be executed in any endoscopy unit in the scope of the endoscopic pretreatment and does not require general anesthesia, which is often necessary for extracorporeal shock wave lithotripsy.

scholarly journals Stone Formation from Nonabsorbable Clip Migration into the Collecting System after Robot-Assisted Partial Nephrectomy

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Ziho Lee ◽  
Christopher E. Reilly ◽  
Blake W. Moore ◽  
Jack H. Mydlo ◽  
David I. Lee ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Stone Formation ◽  
Renal Calculus ◽  
Laser Lithotripsy ◽  
Robot Assisted ◽  
System A ◽  
Flexible Ureteroscope ◽  
Tomography Scan ◽  
Left Middle ◽  
Collecting System

We describe a case in which a Weck Hem-o-lok clip (Teleflex, Research Triangle Park, USA) migrated into the collecting system and acted as a nidus for stone formation in a patient after robot-assisted partial nephrectomy. The patient presented 2 years postoperatively with left-sided renal colic. Abdominal computed tomography scan showed a 10 millimeter renal calculus in the left middle pole. After using laser lithotripsy to fragment the overlying renal stone, a Weck Hem-o-lok clip was found to be embedded in the collecting system. A laser fiber through a flexible ureteroscope was used to successfully dislodge the clip from the renal parenchyma, and a stone basket was used to extract the clip.

Sign in / Sign up

Export Citation Format

Share Document