New management of hepatolithiasis: Can surgery be avoided? (with video).
Gastroenterol Hepatol
; 43(4): 188-192, 2020 Apr.
Article
em En, Es
| MEDLINE
| ID: mdl-32122681
ABSTRACT
BACKGROUND:
The presence of hepatolithiasis (HL) is prevalent in eastern countries. It is a clinical entity which is rarely reported in non-surgical series because the standard treatment is the surgical option. Currently, treatment has evolved, with the use of endoscopic techniques being increased and the number of hepatectomies being decreased. SpyGlass™ is a small-calibre endoscopic direct cholangiopancreatoscopy developed to explore and perform procedures in the bile and pancreatic ducts. Single-operator peroral cholangioscopy (POC) is an endoscopic technique useful for treating difficult bile duct stones.AIMS:
To assess the usefulness, efficacy, and safety of POC with the SpyGlass™ system in patients with HL. PRIMARYOBJECTIVES:
to achieve technical success of the procedure and clinical success of patients with HL. STUDY DESIGN AND PATIENTS Retrospective, single-centre cohort study of patients with HL from April 2012 to August 2018. SpyGlass™ was chosen in symptomatic patients referred from the surgery unit as the first-line procedure. To perform electrohydraulic lithotripsy (EHL), we used a Northgate Autolith IEHL generator with a 0.66-mm biliary probe.RESULTS:
We performed a total of 13 procedures in 7 patients with HL. The mean age was 46 years (range 35-65) and 3/7 of patients were female. We achieved technical success in 5/7 cases (71.4%) and clinical success in 4/7 cases (57%).DISCUSSION:
SpyGlass™ is safe and effective in the treatment of HL. With these results, we confirm the need for management of patients with HL in a multidisciplinary team. When the endoscopic approach is the option, this procedure must be performed by experts in advanced endoscopy.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Litotripsia
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Colelitíase
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Colangiopancreatografia Retrógrada Endoscópica
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Endoscópios
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Hepatopatias
Tipo de estudo:
Observational_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
/
Es
Revista:
Gastroenterol Hepatol
Ano de publicação:
2020
Tipo de documento:
Article