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
References
1. Lammert (Chairman) F., Acalovschi M., Ercolani G., van Erpecum K. J., Gurusamy K. S., van Laarhoven C. J., Portincasa P. EASL Clinical Practice Guidelines on the prevention, diagnosis and treatment of gallstones // J Hepatol. 2016;65(1):146–181. Doi: 10.1016/j.jhep.2016.03.005.
2. Tazuma S., Unno M., Igarashi Y., Inui K., Uchiyama K., Kai M., Tsuyuguchi T., Maguchi H., Mori T., Yamaguchi K., Ryozawa S., Nimura Y., Fujita N., Kubota K., Shoda J., Tabata M., Mine T., Sugano K., Watanabe M., Shimosegawa T. Evidence-based clinical practice guidelines for cholelithiasis 2016 // J. Gastroenterol. 2017;52(3):276–300. Doi: 10.1007/s00535-016-1289-7.
3. Buxbaum J. L., Abbas Fehmi S. M., Sultan S., Fishman D. S., Qumseya B. J., Cortessis V. K., Schilperoort H., Kysh L., Matsuoka L., Yachimski P., Agrawal D., Gurudu S. R., Jamil L. H., Jue T. L., Khashab M. A., Law J. K., Lee J. K., Naveed M., Sawhney M. S., Thosani N., Yang J., Wani S. B. ASGE guideline on the role of endoscopy in the evaluation and management of choledocholithiasis // Gastrointest. Endosc. 2019;89(6):1075–1105. Doi: 10.1016/j.gie.2018.10.001.
4. Merzlikin N. V., Podgornov V. F., Semichev E. V., Bushlanov P. S., Talacheva V. D. Methods of choledocholithiasis treatment // Bulletin of Siberian medicine. 2015;14(4):99–109. (In Russ.).
5. Martov A. G., Gudkov A. V., Diamant V. M., CHepovetskij G. I., Lerner M. I. Comparative study of electro-pulse and electrohydraulic lithotriptors efficiency in vitro // Experimental and clinical urology. 2013;(4):90–97. (In Russ.).
6. Babak A. I., Mozhaeva E. A., Raskovalov D. A., Andrienko I. S., Prudkov M. I. Transfistular nanoelectroimpulse lithotripsy in the treatment of choledocholithiasis // Bulletin of Military medical academy. 2019;(S1):25–28. (In Russ.).
7. Anderloni A., Auriemma F., Fugazza A., Troncone E., Maia L., Maselli R., Carrara S., D’Amico F., Belletrutti P. J., Repici A. Direct peroral cholangioscopy in the management of difficult biliary stones: a new tool to confirm common bile duct clearance. Results of a preliminary study // J. Gastrointestin. Liver Dis. 2019;28(1):89–94. Doi: 10.15403/jgld.2014.1121.281.bil.
8. Ishida Y., Itoi T., Okabe Y. Current Status and Future Perspective in Cholangiopancreatoscopy // Curr. Treat. Options Gastroenterol. 2019;17(3): 327–341. Doi: 10.1007/s11938-019-00238-1.
9. Maydeo A. P., Rerknimitr R., Lau J. Y., Aljebreen A., Niaz S. K., Itoi T., Ang T. L., Reichenberger J., Seo D. W., Ramchandani M. K., Devereaux B. M., Lee J. K., Goenka M. K., Sud R., Nguyen N. Q., Kochhar R., Peetermans J., Goswamy P. G., Rousseau M., Bhandari S. P., Angsuwatcharakon P., Tang R. S. Y., Teoh A. Y. B., Almadi M., Lee Y. N., Moon J. H. Cholangioscopy-guided lithotripsy for difficult bile duct stone clearance in a single session of ERCP: results from a large multinational registry demonstrate high success rates // Endoscopy. 2019;51(10):4. Doi: 10.1055/a-0942-9336.
10. Sejpal D. V., Trindade A. J., Lee C., Miller L. S., Benias P. C., Inamdar S., Singh G., Stewart M., George B. J., Vegesna A. K. Digital cholangioscopy can detect residual biliary stones missed by occlusion cholangiogram in ERCP: a prospective tandem study // Endosc. Int. Open. 2019;7(4):E608–E614. Doi: 10.1055/a-0842-6450.
11. Manes G., Paspatis G., Aabakken L., Anderloni A., Arvanitakis M., AhSoune P., Barthet M., Domagk D., Dumonceau J. M., Gigot J. F., Hritz I., Karamanolis G., Laghi A., Mariani A., Paraskeva K., Pohl J., Ponchon T., Swahn F., Ter Steege R. W. F., Tringali A., Vezakis A., Williams E. J., van Hooft J. E. Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline // Endoscopy. 2019;51(5):472–491. Doi: 10.1055/a-0862-0346.
12. Romashchenko P. N., Fekliunin A. A., Maistrenko N. A., Filin A. A., Omran V. S., Zherebtsov E. S. Transpapillary endoscopic surgery: predictors of complications and prevention of their development // Endoscopic Surgery. 2021;27(1):40–48. (In Russ.). Doi: 10.17116/endoskop20212701140.
13. Romashhenko P. N. Strukov E. J. Acute pancreatitis: aspects of diagnosis and treatment. Lecture. SPb.: ELBI-SPb. 2013. P. 48. (In Russ.).
14. Romashchenko P. N., Filin A. A., Maistrenko N. A., Fekliunin A. A., Zherebtsov E. S Transpapillary endoscopic surgery: complications and prevention of their development // Bulletin of Military medical academy. 2019;(S1):54–58. (In Russ.).
15. Hakuta R., Kawahata S., Kogure H., Nakai Y., Saito K., Saito T., Hamada T., Takahara N., Uchino R., Mizuno S., Tsujino T., Tada M., Sakamoto N., Isayama H., Koike K. Endoscopic papillary large balloon dilation and endoscopic papillary balloon dilation both without sphincterotomy for removal of large bile duct stones: A propensity-matched analysis // Dig. Endosc. 2019;31(1):59–68. Doi: 10.1111/den.13220.
Supplementary files
Review
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
Views:
376
Email this article 