Percutaneous transhepatic Laser lithotripsy for intrahepatic cholelithiasis

Lamanna, Anthony; Maingard, Julian; Tai, James; Ranatunga, Dinesh; Goodwin, Mark

doi:10.1016/j.diii.2019.05.007

Cited by 16 publications

(11 citation statements)

References 15 publications

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“…With its thin and straight mirror body and clear field of vision, the percutaneous nephroscope can accurately reach the location of the stone, and determine the size, character, quantity, incarceration, inflammation, and other conditions of the stone, so as to provide a solid foundation for stone extraction. In this study, the stone extraction rate of PTCSL was 100%, of which 72% of the cases required only one operation, 22% required a second operation, 6% of the patients needed 3 operations for complete removal of stones, which was similar to the results of Lamanna et al 7 Percutaneous nephroscopy has the advantages of being minimally invasive, simple, effective and easy to repeat in the removal of intrahepatic and extrahepatic choledocholithiasis. 8 The traditional method of expanding the sinus is to start with an 8-Fr dilator, and then gradually expand to 16-Fr.…”

Section: Discussionsupporting

confidence: 87%

Percutaneous Transhepatic Choledochoscopic Lithotomy (PTCSL) is Effective for the Treatment of Intrahepatic and Extrahepatic Choledocholithiasis

Zhuo

Chen

Lin

et al. 2020

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: To explore percutaneous transhepatic choledochoscopic lithotomy (PTCSL) as a treatment for intrahepatic and extrahepatic choledocholithiasis.Patient and Methods: A retrospective review of 67 patients with intrahepatic and extrahepatic choledocholithiasis treated by PTCSL from January 2014 to January 2019, including 36 males and 31 females, with an average age of 66 years. During the operation, the doctor established a channel through a 16-Fr Amplatz sheath and removed the stone in the channel with the aid of nephroscope. The clinical efficacy and complications of all patients were analyzed.Results: Sixty-seven patients (67/67, 100%) had their stones successfully removed in the first operation. Only 2 patients (2/67, 3.0%) developed mild reactive pleural effusion after the operation, and 1 patient (1/67, 1.5%) with cholangiocarcinoma after the operation. The incidence of severe bleeding during the operation was 0%. Conclusion:PTCSL is a minimally invasive, simple, effective and easy to repeat procedure for use in the clinic. It is an effective surgical treatment and is worthy of clinical use.

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Section: Discussionsupporting

confidence: 87%

Percutaneous Transhepatic Choledochoscopic Lithotomy (PTCSL) is Effective for the Treatment of Intrahepatic and Extrahepatic Choledocholithiasis

Zhuo

Chen

Lin

et al. 2020

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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“…Percutaneous transhepatic biliary laser lithotripsy is an accepted alternative to ERCP at our institution for the treatment of biliary calculi in the aforementioned patients. We have been performing percutaneous transhepatic biliary laser lithotripsy at our institution for more than 10 years with our results suggesting that this procedure is technically feasible, effective and safe with modest long‐term outcomes …”

Section: Indicationsmentioning

confidence: 99%

“…We have been performing percutaneous transhepatic biliary laser lithotripsy at our institution for more than 10 years with our results suggesting that this procedure is technically feasible, effective and safe with modest long-term outcomes. 15 All patients undergo routine preprocedural blood tests ( Table 1) and imaging. Preprocedural multiplanar multisequence magnetic resonance cholangiopancreatography (MRCP) is performed to produce both 2D and 3D MRCP images.…”

Section: Procedural Planningmentioning

confidence: 99%

Percutaneous transhepatic laser lithotripsy for intrahepatic cholelithiasis: A technical report

et al. 2019

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Summary Advances in interventional radiology have seen the adaptation of urological endoscopic laser techniques to treat biliary tract calculi. Percutaneous transhepatic biliary laser lithotripsy provides an effective alternative procedure for the management of intrahepatic or conventionally refractory choledocholithiasis which would otherwise require invasive and high‐risk surgical intervention. Several small studies have validated the procedure for management in this subset of patients, with most achieving 100% calculi clearance with minimal complications. Most patients are suitable for percutaneous transhepatic biliary laser lithotripsy. Preprocedural imaging is useful for evaluating stone burden and planning percutaneous access. Holmium lasers are commonly used and act by vaporising water particles on and in the calculi, fragmenting the stone via thermal expansion. A series of catheters, wires, sheaths and dilators are used to allow introduction of the choledochoscope and laser so that calculi can be targeted. Percutaneous transhepatic biliary laser lithotripsy is often used in conjunction with balloon dredging and biliary stricture dilatation. Only experienced interventionalists should perform this procedure, and users should be aware of associated hazards. Repeat percutaneous transhepatic cholangiography is routinely performed to confirm eradication of stones. Treatment of biliary calculi and obstruction is important in preventing diseases such as cholangitis and cirrhosis. For patients unsuitable for conventional treatment, percutaneous transhepatic laser lithotripsy is a safe and effective alternative when performed by experienced interventional radiologists. Preprocedural planning is imperative to procedure success.

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“…In other patients, due to poor general conditions, hepatectomy was not tolerated and ERCP failed to clear large IHDs (16). In the above cases, PTCSL is considered as a good alternative because of less hepatic parenchyma injury, low complication rate, high removal rate of target stones and strong repeatability (17)(18)(19). Although PTCSL has a limited clearance rate for multiple IHDs, there have been studies in which single-step multi-channel PTCSL surgery is used to treat bilateral IHDs with increased stone clearance (20).…”

Section: Discussionmentioning

confidence: 99%

Value of multidisciplinary team (MDT) in minimally invasive treatment of complex intrahepatic bile duct stones

Zhang

et al. 2021

BST

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Percutaneous transhepatic Laser lithotripsy for intrahepatic cholelithiasis

Cited by 16 publications

References 15 publications

Percutaneous Transhepatic Choledochoscopic Lithotomy (PTCSL) is Effective for the Treatment of Intrahepatic and Extrahepatic Choledocholithiasis

Percutaneous Transhepatic Choledochoscopic Lithotomy (PTCSL) is Effective for the Treatment of Intrahepatic and Extrahepatic Choledocholithiasis

Percutaneous transhepatic laser lithotripsy for intrahepatic cholelithiasis: A technical report

Value of multidisciplinary team (MDT) in minimally invasive treatment of complex intrahepatic bile duct stones

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