Safety and Efficacy of Extracorporeal Shock Wave Lithotripsy for Difficult-to-retrieve Common Bile Duct Stones: A Ten-year Experience.

Autor:	Manzoor Ul Haque M; Sindh Institute of Urology and Transplantation, Karachi, Sindh, Pakistan., Hassan Luck N; Sindh Institute of Urology and Transplantation, Karachi, Sindh, Pakistan., Ali Tasneem A; Sindh Institute of Urology and Transplantation, Karachi, Sindh, Pakistan., Mudassir Laeeq S; Sindh Institute of Urology and Transplantation, Karachi, Sindh, Pakistan., Mandhwani R; Sindh Institute of Urology and Transplantation, Karachi, Sindh, Pakistan., Hanif FM; Sindh Institute of Urology and Transplantation, Karachi, Sindh, Pakistan., Ullah Lail G; Sindh Institute of Urology and Transplantation, Karachi, Sindh, Pakistan.
Jazyk:	angličtina
Zdroj:	Journal of translational internal medicine [J Transl Int Med] 2020 Sep 25; Vol. 8 (3), pp. 159-164. Date of Electronic Publication: 2020 Sep 25 (Print Publication: 2020).
DOI:	10.2478/jtim-2020-0025
Abstrakt:	Background and Objective: Extracorporeal shock wave lithotripsy (ESWL) for common bile duct (CBD) stones has been used in the past, but experience is limited. We report our experience of ESWL in the management of difficult CBD stones. Methods: Patients with difficult-to-retrieve CBD stones were enrolled and underwent ESWL. Fluoroscopy is used to target the stones after injection of contrast via nasobiliary drain. CBD clearance was the main outcome of the study. Results: Eighty-three patients were included (mean age 50.5 ± 14.5 years); these patients were mainly females (43; 51.8%). Large stones >15 mm were noted in 64 (77.1%), CBD stricture in 22 (26.5%) and incarcerated stone in 8 (9.6%) patients. Patients needed 2.1 ± 1.2 sessions of lithotripsy and 4266 ± 1881 shock waves per session. In 75 (90.3%) patients, the fragments were extracted endoscopically after ESWL, while spontaneous passage was observed in 8 (9.6%). Total CBD clearance was achieved in 67 (80.6%) patients, partial clearance in 5 (6%) and no response in 11 (13.2%). Failure of the treatment was observed in large stone with size ≥2 cm ( P = 0.021), incarcerated stone ( P = 0.020) and pre-endoscopic retrograde cholangiopancreatography cholangitis ( P = 0.047). Conclusion: ESWL is a noninvasive, safe and effective therapeutic alternative to electrohydraulic lithotripsy and surgical exploration for difficult biliary stones. Competing Interests: Conflict of Interest The authors have no financial conflict of interest. (© 2020 Muhammad Manzoor ul Haque, Nasir Hassan Luck, Abbas Ali Tasneem, Syed Mudassir Laeeq, Rajesh Mandhwani, Farina M. Hanif, Ghulam Ullah Lail, published by Sciendo.)
Databáze:	MEDLINE
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