Document Detail

The role of extracorporeal shock wave lithotripsy combined with endoscopic management of impacted cystic duct stones in patients with high surgical risk.
MedLine Citation:
PMID:  16001622     Owner:  NLM     Status:  MEDLINE    
BACKGROUND/AIMS: Cholecystoscopic lithotripsy can be an alternative procedure for the treatment of impacted cystic duct stones in patients who are high risk for surgery. Conventional methods, including electrohydraulic lithotripsy (EHL), occasionally fail due to the inability to access or capture the impacted stones in the narrow, spirally long cystic duct. Using extracorporeal shock wave lithotripsy (ESWL) may be more effective to disintegrate cystic duct stones. The aim of the study is to evaluate the role of ESWL in the endoscopic treatment of impacted cystic duct stones in patients with high operative risk. METHODOLOGY: Eleven patients with impacted cystic duct stones who were at high risk for surgery were included in this study. All of them had had a failed initial attempt of percutaneous transhepatic cholecystoscopic lithotripsy (PTCCS-L) followed by percutaneous transhepatic cholecystostomy. Patients underwent ESWL to disintegrate cystic duct stones with endoscopic removal of fragmented stones. RESULTS: Complete removal of cystic duct stones was achieved in 9 of 11 patients (81.8%). One of the 9 patients (11.1%) was treated solely with ESWL, but the other 8 patients (88.9%) required cholecystoscopic removal of residual fragmented stones after ESWL. Fragmented stones passing through the cystic duct impacted in ampullary region in 3 patients after ESWL. Two patients required transpapillary removal of stones. CONCLUSIONS: Endoscopic stone removal after ESWL for impacted cystic duct stones is a difficult and time-consuming procedure. But, it seems to be a relatively safe alternative to surgery in patients with high surgical risk.
Chan Sup Shim; Jong Ho Moon; Young Deok Cho; Young Seok Kim; Su Jin Hong; Jin Oh Kim; Joo Young Cho; Yun Soo Kim; Joon Seong Lee; Moon Sung Lee
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  52     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2005 Jul-Aug
Date Detail:
Created Date:  2005-07-08     Completed Date:  2005-08-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  1026-9     Citation Subset:  IM    
Institute for Digestive Research, Digestive Disease Center, Soon Chun Hyang University College of Medicine, Seoul, Korea.
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MeSH Terms
Aged, 80 and over
Bile Duct Diseases / radiography,  therapy*,  ultrasonography
Cystic Duct*
Endoscopy, Digestive System*
Follow-Up Studies
Gallstones / radiography,  therapy*,  ultrasonography
Lithotripsy / methods*
Middle Aged
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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