Division of Gastroenterology, Department of Internal Medicine, SoonChunHyang University College of Medicine, Cheonan Hospital, Cheonan, Republic of Korea.
Division of Gastroenterology, Department of Internal Medicine, SoonChunHyang University College of Medicine, Bucheon Hospital, Bucheon, Republic of Korea.
Dig Dis Sci. 2022 Jun;67(6):2571-2576. doi: 10.1007/s10620-021-07068-1. Epub 2021 Jun 4.
The detection of residual or fragmented common bile duct (CBD) stones after lithotripsy can be improved by the high-resolution imaging quality of digital, single-operator cholangioscopy (SOC). However, therapeutic interventions for the removal of residual CBD stones are limited by the lack of appropriate tools. We retrospectively evaluated the role of SOC and the newly developed Dormia basket for the evaluation and removal of stones remaining after lithotripsy.
Thirty-four patients who had undergone lithotripsy for retained CBD stones with no evidence of filling defects in occluded balloon cholangiography from March 2017 to October 2018 were included in the study. After balloon cholangiography, the bile duct was evaluated by SOC for complete evacuation of the stones. The detected residual CBD stones were directly retrieved by inserting the newly developed Dormia basket into the working channel of the SOC. The incidence of residual stones detected by SOC and the success rate of residual stone retrieval by SOC were investigated.
Digital SOC was successfully performed in all patients. Of these, 11 patients (32.4%) had residual CBD stones. The residual stones were successfully removed in 10 patients (90.9%) by SOC using the Dormia basket, except in one case of residual stones left in the hepatic duct. There were no adverse events associated with the SOC procedures or direct stone removal.
Digital SOC combined with the newly developed Dormia basket was useful for the detection and extraction of residual CBD stones under direct visualization after lithotripsy.
数字式、单操作孔胆管镜（SOC）具有高分辨率成像质量，有助于提高碎石术后残留或碎裂的胆总管（CBD）结石的检出率。然而，由于缺乏合适的工具，治疗性干预措施难以用于清除残留的 CBD 结石。我们回顾性评估了 SOC 和新开发的 Dormia 篮在碎石术后评估和清除残留 CBD 结石中的作用。
2017 年 3 月至 2018 年 10 月，我们对 34 例接受碎石术治疗后发现残留 CBD 结石但球囊胆管造影未见充盈缺损的患者进行了研究。球囊胆管造影后，通过 SOC 对胆管进行评估，以确定结石是否完全排出。直接将新开发的 Dormia 篮插入 SOC 的工作通道，以取出 SOC 检测到的残留 CBD 结石。我们调查了 SOC 检测到的残留结石发生率和 SOC 直接取石的成功率。
所有患者均成功进行了数字 SOC。其中，11 例（32.4%）患者有残留 CBD 结石。通过 SOC 使用 Dormia 篮成功取出 10 例（90.9%）患者的残留结石，仅 1 例患者肝内胆管残留结石。SOC 操作或直接取石均未发生不良事件。
数字 SOC 联合新开发的 Dormia 篮可用于在碎石术后直接可视化条件下检测和提取残留的 CBD 结石。
