Transpapillary nanoelectroimpulse choledocholithotripsy under the visualization of SpyGlass imaging
https://doi.org/10.24884/0042-4625-2021-180-6-80-85
Abstract
The clinical case of treatment of the patient with gallstone disease complicated by phlegmonous calculous cholecystitis, choledocholithiasis, obstructive jaundice and purulent cholangitis is presented. The combination of such dangerous complications requires urgent surgical treatment, the minimum amount of which is cholecystectomy and bile duct external drainage at the first stage of treatment. In this case, the simultaneous elimination of choledocholithiasis was considered unjustifiably traumatic and not rational due to the large size of the concretion (13 mm). We also decided to refuse the wide endoscopic papillosphincterotomy. At the second stage of treatment, under the control of transpapillary choledochoscopy, nanoelectroimpulse choledocholithotripsy was performed with the destruction of a dense concretion of choledochus without damaging the surrounding tissues and the sphincter apparatus of the large papilla of the duodenum, which eliminates the likelihood of complications arising after papillosphincterotomy.
About the Authors
P. N. Romashchenko
Military Medical Academy
Russian Federation
Competing Interests:
Russian Federation
Romashchenko Pavel N. - Dr. of Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences, Head of the Department of Faculty Surgery named after S. P. Fedorov.
Saint Petersburg
Competing Interests:
The authors declare no conflict of interest
N. A. Maistrenko
Military Medical Academy
Russian Federation
Competing Interests:
Russian Federation
Maistrenko Nikolay A. - Dr. of Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, Professor of the Department of Faculty Surgery named after S. P. Fedorov, MMA.
Saint Petersburg
Competing Interests:
The authors declare no conflict of interest
A. A. Kurygin
Military Medical Academy
Russian Federation
Competing Interests:
Russian Federation
Kurygin Aleksandr A. - Dr. of Sci. (Med.), Professor, Associate Professor of the Department of Faculty Surgery named after S. P. Fedorov.
Saint Petersburg
Competing Interests:
The authors declare no conflict of interest
E. S. Zherebtsov
Military Medical Academy
Russian Federation
Competing Interests:
Russian Federation
Zherebtsov Evgeniy S., Adjunct of the Department of Faculty Surgery named after S. P. Fedorov.
6, Academika Lebedeva str., Saint Petersburg, 194044
Competing Interests:
The authors declare no conflict of interest
A. A. Fekliunin
Military Medical Academy
Russian Federation
Competing Interests:
Russian Federation
Fekliunin Alexey A. - Cand. of Sci. (Med.), Senior Lecturer of the Department of Faculty Surgery named after S. P. Fedorov.
Saint Petersburg
Competing Interests:
The authors declare no conflict of interest
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For citations:
Romashchenko P.N., Maistrenko N.A., Kurygin A.A., Zherebtsov E.S., Fekliunin A.A. Transpapillary nanoelectroimpulse choledocholithotripsy under the visualization of SpyGlass imaging. Grekov's Bulletin of Surgery. 2021;180(6):80-85. (In Russ.) https://doi.org/10.24884/0042-4625-2021-180-6-80-85
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