Endoscopic Management of Difficult Bile Duct Stones
More than 90% of all common bile duct concrements can be removed via the endoscopic retrograde route via endoscopic sphincterotomy, stone extraction by baskets and balloon catheters, or mechanical lithotripsy. Oversized, very hard or impacted stones, however, often still resist conventional endoscop...
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| Language: | English |
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Wiley
1992-01-01
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| Series: | Canadian Journal of Gastroenterology |
| Online Access: | http://dx.doi.org/10.1155/1992/175814 |
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| author | Christian Ell |
| author_facet | Christian Ell |
| author_sort | Christian Ell |
| collection | DOAJ |
| description | More than 90% of all common bile duct concrements can be removed via the endoscopic retrograde route via endoscopic sphincterotomy, stone extraction by baskets and balloon catheters, or mechanical lithotripsy. Oversized, very hard or impacted stones, however, often still resist conventional endoscopic therapy. Promising new or improved approaches for the treatment of these stones are intracorporeal or extracorporeal shock wave lithotripsy. Shockwave lithotriptors for extracorporeal shockwave lithotripsy are currently available worldwide. However, for the waterbath first generation devices, general anesthesia is required since shockwaves are very painful. Furthermore, an x-ray localization system is essential to visualize the stones after having filled the bile duct over a nasobiliary catheter. An average of two shockwave treatments with additional two to four endoscopic sessions are required. ln tracorporeal lithotripsy promises more comfort and less effort for the patient. Shockwaves are generated either by means of the spark gap principle (electrohydraulic probes) or by laser-induced plasma generation. Laser-induced shockwave lithotripsy appears to be more safer, since with dye and solid state lasers, athermal, well-controlled shockwaves can be generateJ without the risks for duct perfo ration (as described for the electrohydraulic system). Furthermore, a recently developed stone-tissue detection system integrated in a new dye laser system enchances the safety of laser-induced lithotripsy. ln consequence, lithotripsy without direct endoscopic control appears possible in selected cases. |
| format | Article |
| id | doaj-art-9ef3c1e7a73445d086c07b7a584d96a4 |
| institution | OA Journals |
| issn | 0835-7900 |
| language | English |
| publishDate | 1992-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology |
| spelling | doaj-art-9ef3c1e7a73445d086c07b7a584d96a42025-08-20T02:18:32ZengWileyCanadian Journal of Gastroenterology0835-79001992-01-016632332810.1155/1992/175814Endoscopic Management of Difficult Bile Duct StonesChristian Ell0Department of Medicine, Friedrich-Alexander-University Erlangen-Nuremberg, GermanyMore than 90% of all common bile duct concrements can be removed via the endoscopic retrograde route via endoscopic sphincterotomy, stone extraction by baskets and balloon catheters, or mechanical lithotripsy. Oversized, very hard or impacted stones, however, often still resist conventional endoscopic therapy. Promising new or improved approaches for the treatment of these stones are intracorporeal or extracorporeal shock wave lithotripsy. Shockwave lithotriptors for extracorporeal shockwave lithotripsy are currently available worldwide. However, for the waterbath first generation devices, general anesthesia is required since shockwaves are very painful. Furthermore, an x-ray localization system is essential to visualize the stones after having filled the bile duct over a nasobiliary catheter. An average of two shockwave treatments with additional two to four endoscopic sessions are required. ln tracorporeal lithotripsy promises more comfort and less effort for the patient. Shockwaves are generated either by means of the spark gap principle (electrohydraulic probes) or by laser-induced plasma generation. Laser-induced shockwave lithotripsy appears to be more safer, since with dye and solid state lasers, athermal, well-controlled shockwaves can be generateJ without the risks for duct perfo ration (as described for the electrohydraulic system). Furthermore, a recently developed stone-tissue detection system integrated in a new dye laser system enchances the safety of laser-induced lithotripsy. ln consequence, lithotripsy without direct endoscopic control appears possible in selected cases.http://dx.doi.org/10.1155/1992/175814 |
| spellingShingle | Christian Ell Endoscopic Management of Difficult Bile Duct Stones Canadian Journal of Gastroenterology |
| title | Endoscopic Management of Difficult Bile Duct Stones |
| title_full | Endoscopic Management of Difficult Bile Duct Stones |
| title_fullStr | Endoscopic Management of Difficult Bile Duct Stones |
| title_full_unstemmed | Endoscopic Management of Difficult Bile Duct Stones |
| title_short | Endoscopic Management of Difficult Bile Duct Stones |
| title_sort | endoscopic management of difficult bile duct stones |
| url | http://dx.doi.org/10.1155/1992/175814 |
| work_keys_str_mv | AT christianell endoscopicmanagementofdifficultbileductstones |