Introduction: Cholangioscopy is a test that allows the evaluation of the biliary epithelium. It is used for diagnosis and management of biliary diseases.
Objectives: Determine the success rate of complete removal of difficult stones with the use of laser lithotripsy through cholangioscopy as well as its complications. Determine the visual impression accuracy of bile duct injuries.
Materials And Methods: This is a prospective and descriptive study. We included 39 patients between July 2016 and July 2017 with diagnosis of difficult stones in the biliary tract and indeterminate stenosis of the biliary tract that were submitted to cholangioscopy.
Results: Success rate of complete removal of difficult stones was 65.3%, there was one complication. Two laser sessions were required in 4 of the 17 patients who obtained complete removal of the stones. The visual impression accuracy of lesions in the bile duct to determine malignancy coincided in all cases with the final diagnosis of the patient.
Conclusions: Laser lithotripsy allows a safe and effective treatment of the difficult stones of the bile duct. Precession of visual impression of lesions in the bile duct is very high.
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Cureus
November 2024
Department of General Surgery, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Background: Laparoscopic cholecystectomy is a standard minimally invasive technique for the treatment in gallstone disease. In difficult laparoscopic cholecystectomies, bailout strategies have been developed of which the fundus-first technique is one. The present study aims to compare the outcomes of the fundus-first technique against the standard laparoscopic approach in managing difficult cholecystectomy cases by focusing on intraoperative factors such as bleeding, bile duct injury, operative time, and postoperative complications like biliary leakage.
View Article and Find Full Text PDFMed J Armed Forces India
December 2024
CSO Medical, Andaman & Nicobar Command HQ, India.
Background: Lower calyceal anatomy makes the stone clearance a difficult task across all treatment formats. Improvement in optics and miniaturization of instruments have offered an effective and safer alternative to percutaneous nephrolithotomy (PCNL). The study was conducted to compare the efficacy and complications associated with mini-PCNL vs standard-PCNL.
View Article and Find Full Text PDFWorld J Gastrointest Surg
December 2024
Department of Hepatobiliary Surgery, The Second People's Hospital of Foshan, Foshan 528000, Guangdong Province, China.
Hepatolithiasis is a common disease where stones are located in the intrahepatic bile duct. Hepatolithiasis is a disease with regional characteristics. The complication and postoperative recurrence rates of the disease are high.
View Article and Find Full Text PDFSurg Endosc
December 2024
Department of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Background: The treatment of hepatolithiasis in patients who underwent hepaticojejunostomy (HJS) is challenging. In this study, we aimed to clarify the therapeutic outcomes of double balloon enteroscopy (DBE) and percutaneous transhepatic biliary drainage (PTBD) for hepatolithiasis after HJS.
Methods: Patients who underwent DBE or PTBD for hepatolithiasis after HJS at Hiroshima University Hospital were enrolled, and treatment outcomes and recurrence were compared.
Cureus
November 2024
Biochemistry, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND.
Background: Laparoscopic cholecystectomy (LC) is currently the gold standard of care for managing gallstone disease. The time taken to perform LC depends on both patient-related and surgeon-related factors. Recognizing factors associated with difficult LC (DLC) can aid in appropriate surgeon selection and judicious scheduling of cases.
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