Combination of electrohydraulic lithotripsy and laparoscopy for gallbladder access in type III Mirizzi syndrome
| Autor: | Yoshihide Chino, Toshikatsu Nitta, Jun Kataoka, Kensuke Fujii, Masahito Ohta, Takashi Ishibashi, Tomo Tominaga |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Fistula Electrohydraulic lithotripsy 03 medical and health sciences 0302 clinical medicine Lithotripsy Mirizzi Syndrome medicine Humans Laparoscopy medicine.diagnostic_test Common bile duct business.industry Gallbladder General Medicine Middle Aged medicine.disease Combined Modality Therapy Subtotal cholecystectomy Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis Cystic duct 030211 gastroenterology & hepatology Tomography X-Ray Computed business |
| Zdroj: | Asian Journal of Endoscopic Surgery. 12:227-231 |
| ISSN: | 1758-5910 1758-5902 |
| DOI: | 10.1111/ases.12602 |
| Popis: | INTRODUCTION A 50-year-old Japanese man presented with obstructive jaundice. We performed endoscopic retrograde biliary drainage before biliary decompression. CT showed a thickened gallbladder wall with low-density areas and a 35-mm gallstone; the stone was impacted in the gallbladder neck and cystic duct. The patient was therefore diagnosed with Mirizzi syndrome (type II or III) and scheduled for laparoscopic treatment. We performed subtotal cholecystectomy and intraoperative choledochoscopy because we recognized a fistula between the gallbladder and common bile duct preoperatively. MATERIALS AND SURGICAL TECHNIQUE We opened the ductus choledochus, and a choledochoscope was introduced under laparoscopic guidance. An electrohydraulic lithotripsy probe with irrigation was passed through the choledochoscope to extract the gallstone. DISCUSSION This fragmentation technique is effective for impacted large stones observed in Mirizzi syndrome. Therefore, electrohydraulic lithotripsy with laparoscopy is effective in cases of difficult gallbladder access such as that that occurs in type II or III Mirizzi syndrome. |
| Databáze: | OpenAIRE |
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