Impaction of a mechanical lithotripsy basket during endoscopic retrograde cholangiopancreatography is a rare but serious complication resulting from technical failure. We describe a novel case of lithotripsy basket retrieval aided by laser fragmentation. This 87-year-old male underwent an emergency laparoscopic subtotal cholecystectomy, common bile duct (CBD) exploration and laser lithotripsy after attempts at endoscopic mechanical lithotripsy caused a stone-basket complex to become impacted within the CBD. In the absence of endoscopic salvage techniques, laparoscopic CBD exploration is a valid and safe option where surgical expertise permits.
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http://dx.doi.org/10.4103/jmas.jmas_177_24 | DOI Listing |
Background: Stone impaction is an obstacle to successful laparoscopic common bile duct exploration (LCBDE). This study aims to identify the incidence, operative difficulties and techniques used to disimpact and remove impacted stones during LCBDE.
Methods: Prospectively collected data from a large series of LCBDE.
J Vet Intern Med
December 2024
North Carolina Veterinary Hospital, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.
Background: Urocystolithiasis is a common problem in dogs; many canine uroliths are resistant to medical dissolution. Novel management options would expand, and in some cases improve, current urolith retrieval strategies.
Hypothesis/objectives: To describe a previously unreported technique by the Ellik bladder evacuator (EE) to assist in minimally invasive, cystoscopic retrieval of canine cystoliths.
J Hepatobiliary Pancreat Sci
December 2024
Department of Gastroenterology, Saku Central Hospital Advanced Care Center, Nagano, Japan.
Background: Endoscopic sphincterotomy (ES) for bile duct stones (BDS) can cause basket impaction with stone, complicating the procedure. In this study, we evaluated the utility and safety of small incision ES combined with endoscopic papillary balloon dilation (sES + EPBD) (balloon dilated up to the stone size), compared with ES alone for BDS <12 mm.
Methods: The primary endpoint was the frequency of mechanical lithotripsy (ML), indicating the risk of basket impaction with stone; however, the secondary endpoints were procedure time, successful stone removal, and early adverse events.
Pol Przegl Chir
April 2024
Department of General and Transplant Surgery, Medical University of Lodz, Polnad.
<b>Introduction:</b> Choledocholithiasis (CCL) is one of the most common serious health consequences of cholelithiasis. For years, evacuation of stones using endoscopic retrograde cholangiopancreatography (ERCP) has been the first-line treatment. In 10-15% of cases, gallstones cannot be removed using the above-mentioned method and auxiliary methods are necessary; these are so-called difficult gallstones.
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