New management of hepatolithiasis: Can surgery be avoided? (with video).

Autor:	Mansilla-Vivar R; Digestive Endoscopy Unit, Digestive Diseases Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Gastrointestinal Endoscopy Research Group, IIS Hospital La Fe, Valencia, Spain; Digestive Endoscopy Unit, Hospital Puerto Montt, Puerto Montt, Chile. Electronic address: rmansillavivar@gmail.com., Alonso-Lázaro N; Digestive Endoscopy Unit, Digestive Diseases Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Gastrointestinal Endoscopy Research Group, IIS Hospital La Fe, Valencia, Spain., Argüello-Viudez L; Digestive Endoscopy Unit, Digestive Diseases Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Gastrointestinal Endoscopy Research Group, IIS Hospital La Fe, Valencia, Spain., Ponce-Romero M; Digestive Endoscopy Unit, Digestive Diseases Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Gastrointestinal Endoscopy Research Group, IIS Hospital La Fe, Valencia, Spain., Bustamante-Balen M; Digestive Endoscopy Unit, Digestive Diseases Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Gastrointestinal Endoscopy Research Group, IIS Hospital La Fe, Valencia, Spain., Pons-Beltrán V; Digestive Endoscopy Unit, Digestive Diseases Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Gastrointestinal Endoscopy Research Group, IIS Hospital La Fe, Valencia, Spain.
Jazyk:	English; Spanish; Castilian
Zdroj:	Gastroenterologia y hepatologia [Gastroenterol Hepatol] 2020 Apr; Vol. 43 (4), pp. 188-192. Date of Electronic Publication: 2020 Feb 28.
DOI:	10.1016/j.gastrohep.2019.11.008
Abstrakt:	Background: The presence of hepatolithiasis (HL) is prevalent in eastern countries. It is a clinical entity which is rarely reported in non-surgical series because the standard treatment is the surgical option. Currently, treatment has evolved, with the use of endoscopic techniques being increased and the number of hepatectomies being decreased. SpyGlass™ is a small-calibre endoscopic direct cholangiopancreatoscopy developed to explore and perform procedures in the bile and pancreatic ducts. Single-operator peroral cholangioscopy (POC) is an endoscopic technique useful for treating difficult bile duct stones. Aims: To assess the usefulness, efficacy, and safety of POC with the SpyGlass™ system in patients with HL. Primary Objectives: to achieve technical success of the procedure and clinical success of patients with HL. Study Design and Patients: Retrospective, single-centre cohort study of patients with HL from April 2012 to August 2018. SpyGlass™ was chosen in symptomatic patients referred from the surgery unit as the first-line procedure. To perform electrohydraulic lithotripsy (EHL), we used a Northgate Autolith IEHL generator with a 0.66-mm biliary probe. Results: We performed a total of 13 procedures in 7 patients with HL. The mean age was 46 years (range 35-65) and 3/7 of patients were female. We achieved technical success in 5/7 cases (71.4%) and clinical success in 4/7 cases (57%). Discussion: SpyGlass™ is safe and effective in the treatment of HL. With these results, we confirm the need for management of patients with HL in a multidisciplinary team. When the endoscopic approach is the option, this procedure must be performed by experts in advanced endoscopy. (Copyright © 2020 Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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