Laser Lithotripsy by Direct Peroral Cholangioscopy in Complicated Biliary Lithiasis: A Case Series
DOI:
https://doi.org/10.52787/agl.v52i2.165Keywords:
Cholangioscopy, laser lithotripsy, giant lithiasis, microlithiasisAbstract
Common bile duct stones are usually resolved with an endoscopic retrograde cholangiopancreatography. Sometimes, choledocholithiasis becomes a therapeutic challenge, either due to the morphology of the stones, their size, consistency and their relationship with the common bile duct diameter and anatomy. Giant choledocholithiasis poses a therapeutic challenge. Fortunately, we increasingly have more tools for its endoscopic management. Among them we mention, mechanical basket lithotripsy, extracorporeal lithotripsy, and Cholangioscopy guided lithotripsy, electrohydraulic o laser.
We present 2 cases of giant choledocholithiasis treated with cholangioscopy-guided laser litotricia. The first case is a 70-year-old female patient with a history of a cholecystectomy 10 years ago. She was referred to our hospital from another institution for giant choledocholithiasis with two failed endoscopic retrograde cholangiopancreatography attempts.
The second patient is a 58-year-old male patient, also with previous cholecystectomy with 1 previous attempt at endoscopic retrograde cholangiopancreatography for giant choledocholithiasis without success.
Both patients were successfully treated through cholangioscopy-guided laser lithotripsy in a single session and were discharged one day after the procedures.
References
-1. Buxbaum J .Modern management of common bile duct stones. Gastrointest Endosc Clin N Am. 2013;23(2):251-75.
-2. Yasuda I, Itoi T. Recent advances in endoscopic management of difficult bile duct stones. Dig Endosc. 2013;25(4):376-85.
-3. Patel SN, Rosenkranz L, Hooks B, Tarnasky PR, Raijman I, Fishman DS, Sauer BG, Kahaleh M. Holmium-yttrium aluminum garnet laser lithotripsy in the treatment of biliary calculi using single-operator cholangioscopy: a multicenter experience (with video). Gastrointest Endosc. 2014;79(2):344-8.
-4. Manes G, Paspatis G, Aabakken L, Anderloni A, Arvanitakis M, Ah-Soune P, Barthet M, Domagk D, Dumonceau JM, Gigot JF, Hritz I, -5. Karamanolis G, Laghi A, Mariani A, Paraskeva K, Pohl J, Ponchon T, Swahn F, Ter Steege RWF, Tringali A, Vezakis A, Williams EJ, van Hooft JE. Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy. 2019;51(5):472-91.
-5. Kedia P, Tarnasky PR. Endoscopic Management of Complex Biliary Stone Disease. Gastrointest Endosc Clin N Am. 2019;29(2):257-75.
-6. Steiner R. Laser lithotripsy: Clinical use and technical aspects, Springer-Verlag, Berlín. 1988.
-7. Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline.
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Copyright (c) 2022 Victor Hugo Abecia, Fernando Ignacio Gimenez, Manuel Mahler, Dante Manazzoni, Juan Pizzala, Augusto Villaverde, Mariano Marcolongo
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