Hochberger J, Hahn E G, Ell C
Medizinische Klinik I mit Poliklinik, Friedrich-Alexander-Universität, Erlangen-Nürnberg.
Ther Umsch. 1993 Aug;50(8):596-601.
Currently more than 90% of all common bile duct stones can be removed non-surgically by means of endoscopic sphincterotomy, stone extraction and mechanical lithotripsy. For impacted, very large or very hard concrements intracorporeal shock wave lithotripsy by means of pulsed lasers represents a clinically newly established treatment procedure. Most clinical experience exists using the pulsed dye laser applied cholangioscopically via the endoscopic-retrograde or percutaneous-transhepatic route. The development of commercially available fine-caliber-endoscopes allows a relatively easy access to the stone compared to conventional mother-baby-scope-systems. A new stone-tissue-detection-system (STDS) in combination with a rhodamine-6G dye laser is promising for "blind" laser-lithotripsy using standard ERCP- or balloon catheters or a special lithotriptor basket. After successful conclusion of our in vitro and animal studies concerning the STD system we report on 18 patients with giant common bile duct stones using STDS in combination with a Rhodamin-6G dye laser.
目前，超过90%的胆总管结石可通过内镜括约肌切开术、取石术和机械碎石术等非手术方法取出。对于嵌顿性、非常大或非常硬的结石，通过脉冲激光进行体内冲击波碎石术是一种新确立的临床治疗方法。大多数临床经验是使用通过内镜逆行或经皮肝穿刺途径经胆管镜应用的脉冲染料激光。与传统的子母镜系统相比，市售细口径内镜的发展使得相对容易接近结石。一种结合罗丹明-6G染料激光的新型结石组织检测系统（STDS）有望用于使用标准内镜逆行胰胆管造影（ERCP）导管或球囊导管或特殊碎石篮进行“盲法”激光碎石术。在成功完成关于STDS系统的体外和动物研究后，我们报告了18例使用STDS结合罗丹明-6G染料激光治疗巨大胆总管结石的患者。
