O'Leary D P, Cave D R, Greenfield A, Kuligowska E, Birkett D H
Department of Surgery, University Hospital, Boston, Massachusetts 02118.
Gastrointest Endosc. 1991 Mar-Apr;37(2):143-6. doi: 10.1016/s0016-5107(91)70672-x.
We have evaluated the efficacy and safety of pulsed dye laser lithotripsy of gallbladder calculi using a percutaneous endoscopic technique in a porcine model. Fragmentation was readily achieved in vivo. Using a combination of laser lithotripsy and saline lavage, complete removal of all stone debris was feasible through a 24 F tract (N = 3). However, the degree of fragmentation required rendered removal through a smaller tract inefficient, a mean 53% of stone mass being retrievable through a 16 F tract (N = 11). Repeated laser activation at 1 mm from the gallbladder mucosa produced minimal injury, regardless of pulse energy. When the laser fiber was pressed against the mucosa, perforation of the gallbladder was possible at therapeutic pulse energy, but this did not lead to clinical sequelae. We conclude that the pulsed dye laser is a safe and effective means of fragmenting gallbladder calculi in vivo.
我们在猪模型中使用经皮内镜技术评估了脉冲染料激光碎石术治疗胆囊结石的疗效和安全性。在体内很容易实现结石碎裂。联合使用激光碎石术和盐水冲洗，通过24F通道完全清除所有结石碎片是可行的（N = 3）。然而，所需的碎裂程度使得通过较小通道取出结石效率低下，通过16F通道平均可取出53%的结石块（N = 11）。无论脉冲能量如何，在距胆囊黏膜1mm处重复激光激活产生的损伤最小。当激光光纤压在黏膜上时，在治疗脉冲能量下胆囊可能穿孔，但这并未导致临床后遗症。我们得出结论，脉冲染料激光是体内碎裂胆囊结石的一种安全有效的方法。
