Possibilities of methods of intraductal contact lithotripsy with oral transpapillary cholangioscopy in the treatment of «complex» choledocholithiasis

Budzinskiy SA, Zakharova JaS, Fedorov ED, Shapovaliants SG, Tashkinov NV, Vorobeva EA, Kosenko PM. Possibilities of methods of intraductal contact lithotripsy with oral transpapillary cholangioscopy in the treatment of «complex» choledocholithiasis. Endoscopic Surgery. 2022;28(6):22‑30. (In Russ.)
https://doi.org/10.17116/endoskop20222806122

Подписка 2026 Эндоскопическая хирургия (Endoscopic Surgery)

Использование инфографики авторами научных работ

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OBJECTIVE

Comparative analysis of the first results of treatment of patients with «complex» CL using various methods of intraductal CLT.

MATERIAL AND METHODS

A total of 20 patients (13 women, 7 men) were examined. The mean age was 67.1±14.5 years. The disposable system per operator was used, consisting of a miniature video endoscope with a diameter of 10.5 Fr (3.5 mm) and a digital processor, for cholangioscopy. To perform lithotripsy, laser and electrohydraulic lithotripters were used. Features of the anatomy of the parapapillary area were identified in 11 (55%) patients. The size of calculi varied from 8 to 35 mm and averaged 21±8 mm, while calculi with a diameter of up to 15 mm were detected in 4 (20%) patients, 16—25 mm in size — in 11 (55%) patients, more than 25 mm — in 5 (25%) cases.

RESULTS

Complete sanitation of the biliary tract using intraductal contact lithotripsy was achieved in 19 (95%) cases out of 20 cases. The efficiency of fragmentation of biliary stones using a holmium laser reached 93.3%; thulium laser — 100%; electrohydraulic lithotripsy — 66.7%. The average duration of the stone crushing procedure was 13.6±7.5 minutes. The average length of stay of patients in the hospital after using a holmium and thulium laser was 3.4±1.3 and 3±1.7 days, respectively, after electrohydraulic lithotripsy — 4.3±2.1 days.

CONCLUSION

The use of contact lithotripsy during peroral transpapillary cholangioscopy in combination with other retrograde methods of correction increases the effectiveness of the treatment of «complex» choledocholithiasis up to 95%. According to the first data obtained, lithotripsy with a thulium fiber-optic superimpulse laser was the most effective.

Keywords:

choledocholithiasis

cholangioscopy

contact lithotripsy

lithoextraction

Authors:

Budzinskiy S.A.

Pirogov Russian National Research Medical University;
City Clinical Hospital No. 31

ORCID: 0000-0001-7983-7900

Zakharova Ja.S.

Municipal clinical hospital No. 10;
Far Eastern State Medical University

ORCID: 0000-0003-0571-2501

Fedorov E.D.

Pirogov Russian National Research Medical University of the Russian Ministry of Health

SPIN RSCI: 6785-9959
Scopus AuthorID: 7004381289
ORCID: 0000-0002-6036-7061

Shapovaliants S.G.

Pirogov Russian National Research Medical University;
City Clinical Hospital No. 31

ORCID: 0000-0003-0629-3871

Tashkinov N.V.

Far Eastern State Medical University

ORCID: 0000-0001-7473-1250

Vorobeva E.A.

Mental Health Research Centre

ORCID: 0000-0002-5366-2492

Kosenko P.M.

Far Eastern State Medical University

ORCID: 0000-0002-6014-7149

Received:

23.03.2022

Accepted:

01.04.2022

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