Transfistular Nanoelectroimpulse Lithotripsy in the Treatment of Choledocholithiasis

Babak, Alexey; А, Можаева Е; А, Расковалов Д; С, Андриенко И; Prudkov, M. I.

doi:10.17816/brmma13035

Cited by 3 publications

(1 citation statement)

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“…Поэтому при наноэлектроимпульсной литотрипсии, в отличие от электрогидравлической, электрический пробой, создающий ударную волну, происходит не в жидкой среде, а в толще конкремента. Разрушение конкрементов при использовании наноэлектроимпульсной литотрипсии происходит при меньших значениях суммарной энергии и меньшем количестве импульсов, чем при электрогидравлической литотрипсии [51,52].…”

Section: баллонная литоэкстракцияunclassified

Tactics and techniques of choledochal sanation after papillotomy

Май

Короткевич

Леонтьев

et al. 2021

jour

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Сholelithiasis ranks third in terms of the prevalence of diseases among the adult population. A complication such as choledocholithiasis occurs in up to 33% of patients with gallstone disease. Despite the improvement in treatment methods and the use of “gold” standards, the number of complicated forms of cholelithiasis has no tendency to decrease. Timely resolution of choledocholithiasis by a correctly chosen technique helps to reduce complications and increases the frequency of favorable outcomes of the disease, returning patients to social activity.That is why it is important to know and, if possible, to use various methods of rehabilitation of the common bile duct when performing modern endoscopic transpapillary interventions.

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Section: баллонная литоэкстракцияunclassified

Tactics and techniques of choledochal sanation after papillotomy

Май

Короткевич

Леонтьев

et al. 2021

jour

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Choledocholithiasis: modern possibilities of diagnosis and surgical treatment

Zherebtsov

Romashchenko

Maistrenko

2021

Bulletin of the Russian Military Medical Academy

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Studies have examined various approaches in the diagnosis and surgical treatment of patients with cholelithiasis complicated by choledocholithiasis, evaluated the possibilities of using modern methods of treating the disease, and proposed a strategy to prevent the abandonment of bile duct concretions. The relevance of this problem is related to the variety of diagnostic and surgical treatment methods of choledocholithiasis, high disease frequency, and nonexistence of a unified approach to the examination and choice of surgical treatment in patients with cholelithiasis complicated by choledocholithiasis. These issues indicate the need to study this problem and identify optimal approaches to examination and treatment, including modern minimally invasive methods of treatment. The analysis of the diagnostic value of various examination methods and surgical outcomes was based on the experience of treating 154 patients with cholelithiasis complicated by choledocholithiasis in the clinic of the S.P. Fedorov Faculty of Surgery of the S.M. Kirov Military Medical Academy. An algorithm for examining patients with cholelithiasis was formed based on the diagnostic value of various research methods, which allows timely detection of choledocholithiasis. The results of various approaches to the surgical treatment of patients with cholelithiasis complicated by choledocholithiasis were analyzed. In the absence of general somatic contraindications and the availability of technical capabilities, a one-stage approach to surgical treatment was suggested. Moreover, an individual approach is necessary for the treatment of patients with cholelithiasis complicated by choledocholithiasis, taking into account the nature of the disease course and its complications, comorbid status of the patient, and technical capabilities of a particular hospital. The sequence and timing of operations with a two-stage approach should be determined, taking into account the acute conditions and comorbidities of the patient. The use of modern minimally invasive technologies, such as transpapillary and trans-bubble choledochoscopy, dosed papillotomy, and rendezvous technique for the cannulation of the large papilla of the duodenum, allows us to improve the results of surgical treatment and reduce the risk of complications. Transpapillary and trans-bubble nanoelectroimpulse lithotripsy are alternative methods of resolving major choledocholithiasis in both one-stage and two-stage treatment.

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Transpapillary nanoelectroimpulse choledocholithotripsy under the visualization of SpyGlass imaging

Romashchenko¹,

Майстренко²,

Kurygin³

et al. 2022

VESTNIK KHIRURGII IMENI I.I.GREKOVA

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The clinical case of treatment of the patient with gallstone disease complicated by phlegmonous calculous cholecystitis, choledocholithiasis, obstructive jaundice and purulent cholangitis is presented. The combination of such dangerous complications requires urgent surgical treatment, the minimum amount of which is cholecystectomy and bile duct external drainage at the first stage of treatment. In this case, the simultaneous elimination of choledocholithiasis was considered unjustifiably traumatic and not rational due to the large size of the concretion (13 mm). We also decided to refuse the wide endoscopic papillosphincterotomy. At the second stage of treatment, under the control of transpapillary choledochoscopy, nanoelectroimpulse choledocholithotripsy was performed with the destruction of a dense concretion of choledochus without damaging the surrounding tissues and the sphincter apparatus of the large papilla of the duodenum, which eliminates the likelihood of complications arising after papillosphincterotomy.

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Transfistular Nanoelectroimpulse Lithotripsy in the Treatment of Choledocholithiasis

Cited by 3 publications

References 1 publication

Tactics and techniques of choledochal sanation after papillotomy

Tactics and techniques of choledochal sanation after papillotomy

Choledocholithiasis: modern possibilities of diagnosis and surgical treatment

Transpapillary nanoelectroimpulse choledocholithotripsy under the visualization of SpyGlass imaging

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