Lithotripsy of gallstones by means of a quality-switched giant-pulse neodymium:Yttrium-aluminum-garnet laser

Hochberger, J.; Gruber, E.; Wirtz, Peter; Dürr, U.; Kolb, Achim; Zanger, Ulf; Hahn, Eckhart G.; Ell, Christian

doi:10.1016/0016-5085(91)90093-z

Cited by 31 publications

(10 citation statements)

References 20 publications

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“…In humans and animals, LL with 10-W pulses carries a low risk of bile duct injury, and the depth of penetration is less than 1.9 mm. 31,32 The application of a yttrium-aluminum-garnet laser for fragmenting gallstones was initially described by Lux et al 31 and subsequently for pancreatic stones by Neuhaus et al 33,34 In the last decade, LL has been achieved using a!500-mm holmium laser fiber through a 10F Spyglass pancreatoscope. Alatawi et al 35 (n Z 5) and Maydeo et al 36 (n Z 4) reported technical success of 100% and no AEs, although the stones were sub-centimeter and limited to the head and neck regions.…”

Section: Discussionmentioning

confidence: 99%

ERCP with per-oral pancreatoscopy–guided laser lithotripsy for calcific chronic pancreatitis: a multicenter U.S. experience

Attwell

Patel

Kahaleh

et al. 2015

Gastrointestinal Endoscopy

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Section: Discussionmentioning

confidence: 99%

ERCP with per-oral pancreatoscopy–guided laser lithotripsy for calcific chronic pancreatitis: a multicenter U.S. experience

Attwell

Patel

Kahaleh

et al. 2015

Gastrointestinal Endoscopy

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“…Sparks at this site produce high amplitude hydraulic pressure waves during water immersion, which help in stone fragmentation[16]. Neodymium: yttrium-aluminum-garnet lasers have been used for pancreatobiliary stone fragmentation by transforming optical energy into mechanical energy in the form of shockwaves via local plasma formation[17].…”

Section: Resultsmentioning

confidence: 99%

Role of pancreatoscopy in management of pancreatic disease: A systematic review

Kaura

Willingham

Chawla

2019

WJGE

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BACKGROUNDPer-oral pancreatoscopy (POP) plays a role in the diagnosis and therapy of pancreatic diseases. With recent technological advances, there has been renewed interest in this modality.AIMTo evaluate the efficacy and safety of POP in management of pancreatic stone disease and pancreatic ductal neoplasia.METHODSTo determine the safety and efficacy of POP in the management of pancreatic diseases, a systematic search was conducted in MEDLINE, EMBASE and Ovid. Articles in languages other than English and case reports were excluded. All published case series were eligible. Data specific to POP were extracted from studies, which combined cholangiopancreatoscopy. Ten studies were included in the analysis of POP therapy for pancreatic stone disease, and 15 case series satisfied the criteria for inclusion for the role of POP in the management of pancreatic ductal neoplasia. The examined data were subcategorized according to adjunctive modalities, such as direct tissue sampling, cytology, the role of intraoperative POP, intraductal ultrasound (IDUS) and POP combined with image-enhancing technology.RESULTSThe success rate for complete ductal stone clearance ranged from 37.5%-100%. Factors associated with failure included the presence of strictures, multiple stones and the inability to visualize the target area. Although direct visualization can identify malignant and premalignant conditions, there is significant overlap with benign diseases. Visually-directed biopsies provide a high degree of accuracy, and represent a unique approach for tissue acquisition in patients with ductal abnormalities. Addition of pancreatic fluid cytology increases diagnostic yield for indeterminate lesions. Protrusions larger than 3 mm noted on IDUS are significantly more likely to be associated with malignancy. The rate of adverse events associated with POP ranged from 0%-35%.CONCLUSIONCurrent evidence supports wider adoption of pancreatoscopy, as it is safe and effective. Improved patient selection and utilization of novel technologies may further enhance its role in managing pancreatic disease.

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“…Absorption of the laser energy rapidly expands and collapses the plasma, inducing a spherical mechanical shockwave between the laser fiber and stone, leading to stone fragmentation. 22 …”

Section: Innovations In Intraductal Endoscopymentioning

confidence: 97%

Innovations in Intraductal Endoscopy

Shah

2015

Gastrointestinal Endoscopy Clinics of North America

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Lithotripsy of gallstones by means of a quality-switched giant-pulse neodymium:Yttrium-aluminum-garnet laser

Cited by 31 publications

References 20 publications

ERCP with per-oral pancreatoscopy–guided laser lithotripsy for calcific chronic pancreatitis: a multicenter U.S. experience

ERCP with per-oral pancreatoscopy–guided laser lithotripsy for calcific chronic pancreatitis: a multicenter U.S. experience

Role of pancreatoscopy in management of pancreatic disease: A systematic review

Innovations in Intraductal Endoscopy

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