We present a novel minimally invasive technique, laparoscopy-assisted micropercutaneous choledocholithotripsy, for choledocholithiasis that cannot be treated with other endoscopic techniques. This technique includes standard laparoscopic exploration of the common bile duct, combined with an all-seeing needle and holmium laser lithotripsy. As is known, an all-seeing needle is used in micropercutaneous nephrolithotomy for middle-sized renal stones. In this technique, an all-seeing needle was inserted into the dilatated common bile duct under laparoscopic vision and then a lithotripsy procedure was performed with a holmium laser behind the biliary stent. A cholecystectomized female patient with a 21-mm stone in the common bile duct who previously underwent an unsuccessful endoscopic retrograde cholangiopancreatography procedure was operated on in our service with laparoscopy-assisted micropercutaneous choledocholithotomy without a T-tube. This novel procedure was completed uneventfully and the patient was discharged without any complications. In the future, this procedure will hopefully be a treatment modality in choledocholithiasis that cannot be treated by other minimally invasive techniques.
Chronic hepatitis B virus (HBV) infection is one of the leading causes of cirrhosis, liver failure, hepatocellular carcinoma (HCC), liver transplantation and liver-related mortality. 1 Current guidelines recommend entecavir (ETV), tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide fumarate (TAF) as the first-line therapies in chronic hepatitis B (CHB). 1,2 Long-term therapy with these drugs results in suppression of HBV replication in most patients. Maintained suppression of HBV replication leads
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