OBJECTIVES: To evaluate the role of minimally invasive "urologic" interventional techniques for the treatment of pancreaticobiliary calculi in contemporary practice. METHODS: Fourteen patients with retained cystic duct (n = 2), hepatic duct (n = 5), common duct (n = 2), pancreatic duct (n = 4), or gallbladder (n = 1) calculi were treated with 19 procedures, including shock wave lithotripsy (n = 9) and percutaneous flexible endoscopy with electrohydraulic or holmium laser lithotripsy (n = 10). Previous attempts using standard gastroenterologic or radiologic interventions before the urologic referral had failed in all 14 patients. RESULTS: A successful result, defined by the resolution of stones and symptoms, was achieved in 12 patients (86%); 2 patients (14%) had residual calculi that ultimately required an open operative procedure. The hospital stay for each intervention was 0 to 2 nights, and no patients had any significant complications. CONCLUSIONS: Even in this age of advanced gastroenterologic technology, including laparoscopic cholecystectomy, endoscopic retrograde cholangiopancreatoscopy, and percutaneous transhepatic cholangiography, the urologist can play a significant role in the minimally invasive treatment of patients with complicated biliary disease such that the need for open operative "salvage" procedures will be further minimized.
OBJECTIVES: To evaluate the role of minimally invasive "urologic" interventional techniques for the treatment of pancreaticobiliary calculi in contemporary practice. METHODS: Fourteen patients with retained cystic duct (n = 2), hepatic duct (n = 5), common duct (n = 2), pancreatic duct (n = 4), or gallbladder (n = 1) calculi were treated with 19 procedures, including shock wave lithotripsy (n = 9) and percutaneous flexible endoscopy with electrohydraulic or holmium laser lithotripsy (n = 10). Previous attempts using standard gastroenterologic or radiologic interventions before the urologic referral had failed in all 14 patients. RESULTS: A successful result, defined by the resolution of stones and symptoms, was achieved in 12 patients (86%); 2 patients (14%) had residual calculi that ultimately required an open operative procedure. The hospital stay for each intervention was 0 to 2 nights, and no patients had any significant complications. CONCLUSIONS: Even in this age of advanced gastroenterologic technology, including laparoscopic cholecystectomy, endoscopic retrograde cholangiopancreatoscopy, and percutaneous transhepatic cholangiography, the urologist can play a significant role in the minimally invasive treatment of patients with complicated biliary disease such that the need for open operative "salvage" procedures will be further minimized.
Authors: Fernando Korkes; Ariê Carneiro; Felipe Nasser; Breno Boueri Affonso; Francisco Leonardo Galastri; Marcos Belotto de Oliveira; Antônio Luiz de Vasconcellos Macedo Journal: Einstein (Sao Paulo) Date: 2015-06-09
Authors: Rabindra R Watson; Mansour A Parsi; Harry R Aslanian; Adam J Goodman; David R Lichtenstein; Joshua Melson; Udayakumar Navaneethan; Rahul Pannala; Amrita Sethi; Shelby A Sullivan; Nirav C Thosani; Guru Trikudanathan; Arvind J Trindade; John T Maple Journal: VideoGIE Date: 2018-09-26