Neuhaus H, Hoffmann W, Classen M
Department of Internal Medicine II, Technical University, Munich, Germany.
Endoscopy. 1992 Mar;24(3):208-14. doi: 10.1055/s-2007-1010464.
The pulsed dye laser is safe and effective in lithotripsy of biliary and pancreatic ductal stones, however delivery of the laser energy to the site of the calculi is technically difficult. A 3.4 mm miniscope inserted through a standard duodenoscope was used for transpapillary laser application under direct vision in one patient with an impacted pancreatic stone and in three patients with bile duct stones not amenable to treatment by routine endoscopy. Lithotripsy and ductal clearance was achieved in 3 of the 4 patients within a single treatment session. Percutaneous transhepatic laser lithotripsy via a 3.7 mm miniscope succeeded in the patient in whom the peroral approach had failed and in two further patients with bile duct stones not accessible by a retrograde approach. There were no major complications. The miniscopes provide an appropriate direct visual control for laser lithotripsy of pancreatobiliary calculi. This approach using miniscopes seems to be an effective, minimally invasive and time-saving alternative to conventional endoscopic laser lithotripsy.
脉冲染料激光在胆道和胰管结石的碎石术中安全有效，然而，将激光能量传递到结石部位在技术上具有挑战性。在一名患有嵌顿性胰石的患者和三名常规内镜治疗不适用的胆管结石患者中，通过标准十二指肠镜插入一根3.4毫米的微型内镜，用于在直视下经乳头应用激光。4例患者中有3例在单次治疗中实现了碎石和胆管清除。经口途径失败的患者以及另外两名逆行途径无法触及的胆管结石患者，通过一根3.7毫米的微型内镜成功进行了经皮经肝激光碎石术。未发生重大并发症。微型内镜为胰胆结石的激光碎石术提供了适当的直视控制。这种使用微型内镜的方法似乎是一种有效、微创且节省时间的传统内镜激光碎石术替代方案。
