Schreiber F, Gurakuqi G C, Trauner M
Department of Medicine, University Hospital, Karl Franzens University, Graz, Austria.
Gastrointest Endosc. 1995 Nov;42(5):416-9. doi: 10.1016/s0016-5107(95)70042-0.
Endoscopic retrograde intracorporeal lithotripsy with a stone recognition laser system seems to be a promising alternative in patients with difficult bile duct stones.
Sixteen patients with bile duct stones not suitable for endoscopic standard procedures underwent intracorporeal laser lithotripsy during a 3-month period. An average of 6800 (120 to 25000) discharges were applied with a power setting of 100 mJ. Inserting the laser fiber into a radiopaque marked catheter or into a balloon catheter guaranteed a successful location on the stone surface in 70% of all discharges. The automatic feedback/cut-off at the fiber is not in contact with the stone surface.
Fragmentation was achieved in all cases. Complete bile duct clearance was reached in 14/16 cases. In two cases, remaining fragments passed spontaneously through the papilla as controlled by ERCP. Minor complications were noted in two patients (hemobilia, cholangitis). Complete recovery was achieved in both patients with conservative management.
For a selected group of patients with difficult common bile duct stones, intracorporeal laser lithotripsy with a stone recognition laser system was found to be a highly effective and safe technique.
对于患有复杂胆管结石的患者，使用结石识别激光系统进行内镜逆行体内碎石术似乎是一种有前景的替代方法。
在3个月的时间里，16例不适合内镜标准手术的胆管结石患者接受了体内激光碎石术。平均使用6800次（120至25000次）放电，功率设置为100 mJ。将激光光纤插入不透射线标记导管或球囊导管中，在所有放电中70%的情况下能确保成功定位在结石表面。当光纤未与结石表面接触时会自动反馈/切断。
所有病例均实现了结石破碎。16例中有14例实现了胆管完全清除。在2例中，通过内镜逆行胰胆管造影（ERCP）控制，残留碎片自发通过乳头。2例患者出现轻微并发症（胆道出血、胆管炎）。经保守治疗，2例患者均完全康复。
对于一组选定的患有复杂胆总管结石的患者，使用结石识别激光系统进行体内激光碎石术是一种高效且安全的技术。
