Abstract：
OBJECTIVE: The detection of residual or fragmented common bile duct (CBD) stones after lithotripsy can be improved by the high-resolution imaging quality of digital, single-operator cholangioscopy (SOC). However, therapeutic interventions for the removal of residual CBD stones are limited by the lack of appropriate tools. We retrospectively evaluated the role of SOC and the newly developed Dormia basket for the evaluation and removal of stones remaining after lithotripsy.
METHODS: Thirty-four patients who had undergone lithotripsy for retained CBD stones with no evidence of filling defects in occluded balloon cholangiography from March 2017 to October 2018 were included in the study. After balloon cholangiography, the bile duct was evaluated by SOC for complete evacuation of the stones. The detected residual CBD stones were directly retrieved by inserting the newly developed Dormia basket into the working channel of the SOC. The incidence of residual stones detected by SOC and the success rate of residual stone retrieval by SOC were investigated.
RESULTS: Digital SOC was successfully performed in all patients. Of these, 11 patients (32.4%) had residual CBD stones. The residual stones were successfully removed in 10 patients (90.9%) by SOC using the Dormia basket, except in one case of residual stones left in the hepatic duct. There were no adverse events associated with the SOC procedures or direct stone removal.
CONCLUSIONS: Digital SOC combined with the newly developed Dormia basket was useful for the detection and extraction of residual CBD stones under direct visualization after lithotripsy.
METHODS: Thirty-four patients who had undergone lithotripsy for retained CBD stones with no evidence of filling defects in occluded balloon cholangiography from March 2017 to October 2018 were included in the study. After balloon cholangiography, the bile duct was evaluated by SOC for complete evacuation of the stones. The detected residual CBD stones were directly retrieved by inserting the newly developed Dormia basket into the working channel of the SOC. The incidence of residual stones detected by SOC and the success rate of residual stone retrieval by SOC were investigated.
RESULTS: Digital SOC was successfully performed in all patients. Of these, 11 patients (32.4%) had residual CBD stones. The residual stones were successfully removed in 10 patients (90.9%) by SOC using the Dormia basket, except in one case of residual stones left in the hepatic duct. There were no adverse events associated with the SOC procedures or direct stone removal.
CONCLUSIONS: Digital SOC combined with the newly developed Dormia basket was useful for the detection and extraction of residual CBD stones under direct visualization after lithotripsy.
摘要：
目的：碎石后残留或碎裂的胆总管（CBD）结石的检测可以通过数字的高分辨率成像质量来提高，单操作员胆道镜检查（SOC）。然而,由于缺乏适当的工具，用于去除残留CBD结石的治疗干预措施受到限制。我们回顾性评估了SOC和新开发的Dormia篮对评估和清除碎石术后残留结石的作用。
方法：本研究纳入了2017年3月至2018年10月的34例患者，这些患者因保留的CBD结石而接受了碎石术，没有证据表明闭塞的球囊胆管造影存在填充缺陷。球囊胆管造影后,通过SOC评估胆管是否完全排空结石。通过将新开发的Dormia篮插入SOC的工作通道，可以直接取回检测到的残留CBD结石。对SOC检出残石的发生率和SOC取石成功率进行了调查。
结果：所有患者均成功进行了DigitalSOC。其中,11例患者（32.4%）有残留的CBD结石。使用Dormia篮通过SOC成功清除了10例患者（90.9%）的残余结石，除了一例残留在肝导管中的结石。没有与SOC程序或直接取石相关的不良事件。
结论：数字SOC结合新开发的Dormia篮对于碎石术后在直接可视化下检测和提取残留的CBD结石很有用。
方法：本研究纳入了2017年3月至2018年10月的34例患者，这些患者因保留的CBD结石而接受了碎石术，没有证据表明闭塞的球囊胆管造影存在填充缺陷。球囊胆管造影后,通过SOC评估胆管是否完全排空结石。通过将新开发的Dormia篮插入SOC的工作通道，可以直接取回检测到的残留CBD结石。对SOC检出残石的发生率和SOC取石成功率进行了调查。
结果：所有患者均成功进行了DigitalSOC。其中,11例患者（32.4%）有残留的CBD结石。使用Dormia篮通过SOC成功清除了10例患者（90.9%）的残余结石，除了一例残留在肝导管中的结石。没有与SOC程序或直接取石相关的不良事件。
结论：数字SOC结合新开发的Dormia篮对于碎石术后在直接可视化下检测和提取残留的CBD结石很有用。
