Attila Tan, May Gary R, Kortan Paul
University of Toronto, St Michael's Hospital, Advanced Therapeutic Endoscopy and Gastrointestinal Oncology Group, Toronto, Ontario.
Can J Gastroenterol. 2008 Aug;22(8):699-702. doi: 10.1155/2008/798527.
In a patient with a mid-common bile duct stone, the traction wires of a mechanical lithotriptor snapped, resulting in lithotriptor basket impaction. Simultaneous occurrence of these two potential complications of endoscopic stone extraction is very rarely reported. Extracorporeal shock wave lithotripsy failed to fragment the stone entrapped within the impacted basket. Endoscopic intracorporeal electrohydraulic shock wave lithotripsy successfully fragmented the stone under direct visualization through a cholangioscope. The entrapped stone within the basket could subsequently be pulled into the supra-ampullary bile duct for the final fragmentation with an extra-endoscopic mechanical lithotriptor cable. The present report is the first to describe a safe and effective use of endoscopic intracorporeal electrohydraulic shock wave lithotripsy followed by extra-endoscopic mechanical lithotripsy in the management of an impacted lithotriptor basket.
在一名胆总管中段结石患者中，机械碎石器的牵引线断裂，导致碎石器篮筐嵌顿。内镜下取石这两种潜在并发症同时发生的情况鲜有报道。体外冲击波碎石术未能将嵌顿在篮筐内的结石击碎。内镜体内电液压冲击波碎石术通过胆管镜在直视下成功将结石击碎。篮筐内嵌顿的结石随后可被拉入壶腹上胆管，用内镜外机械碎石器缆线进行最终破碎。本报告首次描述了在内镜体内电液压冲击波碎石术联合内镜外机械碎石术处理嵌顿碎石器篮筐时的安全有效应用。
