Abstract
Since the introduction of endoscopic papillotomy (EPT), stone clearance by conventional means has become possible in approximately 85% of cases of choledocholithiasis. Several endoscopic therapies for any remaining stones have been introduced. Laser therapy under direct visual control via the insertion of a cholangioscope, by either peroral transpapillary cholangioscopy (POCS) or percutaneous transhepatic cholangioscopy (PTCS) has proven highly effective, raising the success rate of biliary stone clearance to almost 100%. POCS is technically more difficult and thus has a lower success rate, but is far less time-consuming and causes fewer complications than PTCS. The technical equipment employed for POCS should be further improved. In selected patients, laser application via PTCS is an uncomplicated but highly efficient method; however, the rate of complications and the time needed to establish a transhepatic tract continue to cause problems.
Similar content being viewed by others
References
Classen M, Demling L (1974) Endoscopische Sphinkterotomie der Papilla Vateri und Steinextraktion aus dem Ductus choledochus. Dtsch med Wschr 99:496
Kawai K, Akasaka Y, Murakami K, Tada M, Kokki Y, Nakajima M (1974) Endoscopic sphincterotomy of the ampulla of Vater. Gastrointest Endosc 20:148–151
Cotton PB (1984) Endoscopic management of bile duct stones; apples and oranges. Gut 25:587–597
Nakajima M, Akasaka Y, Fukumoto K, Mitsuyoshi Y, Kawai K (1976) Peroral cholangiopancreatoscopy (PCPC) under duodenoscopic guidance. Am J Gastroenterol 66:241–247
Takada T, Suzuki S, Nakamura K, Uchida Y, Nomoto T, Yamada AK (1974) Studies on percutaneous biliary tract endoscopy. Gastroenterol Endosc 16:106–111
Nimura Y, Hayakawa N, Toyoda S, Iyomasa Y, Nakazawa S (1981) Percutaneous transhepatic cholangioscopy. Stomach Intestine 16:681–689
Nimura Y, Kamiya J, Hayakawa N, Shinoya S (1989) Cholangioscopic differentiation of biliary strictures and polyps. Endoscopy 21:351–356
Kozarek RA (1988) Direct cholangioscopy and pancreatoscopy at time of endoscopic retrograde cholangiopancreatography. Am J Gastroenterol 83:55–57
Komiya O (1989) Technical potential and limitations of cholangioscopes. Endoscopy 21:338–340
Maier M, Kohler B, Benz C, Körber H, Riemann JF (1995) Die perkutan transhepatische Cholangioskopie (PTCS) — Eine wichtige Ergänzung in der Diagnostik und Therapie von Gallenwegserkrankungen (Indikationen, Technik und Ergebnisse). Z Gastroenterol 33:435–439
Neuhaus H, Classen M (1995) Nonsurgical cholangioscopy: The present state. Saudi J Gastroenterol 1:75–80
Ell C, Hochberger J, May A, Fleig WE, Bauer R, Mendez L, Hahn EG (1993) Laser lithotripsy of difficult bile duct stones by means of a rhodamine-6 G laser and an integrated automatic stone-tissue detection system. Gastrointest Endosc 39:755–762
Yamakawa T (1989) Percutaneous cholangioscopy for management of retained biliary tract stones and intrahepatic stones. Endoscopy 21:333–337
Bonnel DH, Liguory CE, Cornud FE, Lefebvre JFP (1991) Common bile duct and intrahepatic stones: Results of transhepatic electrohydraulic lithotripsy in 50 patients. Radiology 180:345–348
Binmöller KF, Brückner M, Thonke F, Soehendra N (1993) Treatment of difficult bile duct stones using mechanical, electrohydraulic and extracorporeal shock wave lithotripsy. Endoscopy 25:201–206
Neuhaus H, Hoffmann W, Zillinger C, Classen M (1993) Laser lithotripsy of difficult bile duct stones under direct visual control. Gut 34:415–421
Born P, Neuhaus H, Classen M (1995) Lasaerlithotripsie schwieriger Gallengangssteine nach Versagen einer extrakorporalen Stoßwellenbehandlung. Z Gastroenterol 33:202–207
Yeh YH, Huang MH, Yang JC, Mo LR, Lin J, Yueh SK (1995) Percutaneous trans-hepatic cholangioscopy and lithotripsy in the treatment of intrahepatic stones: A study with 5-year follow-up. Gastrointest Endosc 42:13–18
Schreiber F, Gurakuqi GC, Trauner M (1995) Endoscopic intracorporeal laser lithotripsy of difficult common bile duct stones with a stone recognition pulsed dye laser system. Gastrointest Endosc 42:416–419
Lambert ME, Betts CD, Hill J, Faragher EB, Martin DF, Tweedle DEF (1991) Endoscopic sphincterotomy: The whole truth. Br J Surg 78:473–476
Born P, Neuhaus H, Ott R, Classen M (1995) A new palliative approach for biliary and duodenal obstruction due to pancreatic and papillary carcinoma. Endoscopy 27:S4
Lorenz R, Lehn N, Born P, Hermann M, Neuhaus H (1996) Antibiotische Prophylaxe mit Cefuroxim bei endoskopischen Eingriffen an den Gallenwegen. Dtsch med Wschr 127:223–230
Liguory CL, Lefebvre JF, Bonnel D, Cornud F, Etienne JP (1989) Indications for cholangioscopy. Endoscopy 21:341–343
Born P, Golder W, Allescher HD, Rösch T, Classen M (1995) Severe arterial bleeding after percutaneous transhepatic cholangiographic drainage. Endoscopy 27:343
Yasuda K, Nakajima M, Cho E, Mukai H, Kawai K (1989) Comparison of peroral and percutaneaus cholangioscopy. Endoscopy 21:347–350
Nimura Y, Kamijy JJ (1996) Cholangioscopy. Endoscopy 28:138–146
Lee JG, Leung JW (1993) Endoscopic lithotripsy for bile duct stones. Acta Gastroenterol Belg 56:207–214
Author information
Authors and Affiliations
About this article
Cite this article
Born, P., Neuhaus, H. & Classen, M. Cholangioscopic laser lithotripsy of common bile duct stones —an overview. J Hep Bil Pancr Surg 4, 11–15 (1997). https://doi.org/10.1007/BF01211337
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01211337