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Biliary and pancreatic lithotripsy devices
- Source :
- VideoGIE
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Background and Aims Lithotripsy is a procedure for fragmentation or destruction of stones to facilitate their removal or passage from the biliary or pancreatic ducts. Although most stones may be removed endoscopically using conventional techniques such as endoscopic sphincterotomy in combination with balloon or basket extraction, lithotripsy may be required for clearance of large, impacted, or irregularly shaped stones. Several modalities have been described, including intracorporeal techniques such as mechanical lithotripsy (ML), electrohydraulic lithotripsy (EHL), and laser lithotripsy, as well as extracorporeal shock-wave lithotripsy (ESWL). Methods In this document, we review devices and methods for biliary and pancreatic lithotripsy and the evidence regarding efficacy, safety, and financial considerations. Results Although many difficult stones can be safely removed using ML, endoscopic papillary balloon dilation (EPBD) has emerged as an alternative that may lessen the need for ML and also reduce the rate of adverse events. EHL and laser lithotripsy are effective at ductal clearance when conventional techniques are unsuccessful, although they usually require direct visualization of the stone by the use of cholangiopancreatoscopy and are often limited to referral centers. ESWL is effective but often requires coordination with urologists and the placement of stents or drains with subsequent procedures for extracting stone fragments and, thus, may be associated with increased costs. Conclusions Several lithotripsy techniques have been described that vary with respect to ease of use, generalizability, and cost. Overall, lithotripsy is a safe and effective treatment for difficult biliary and pancreatic duct stones.
- Subjects :
- medicine.medical_specialty
FDA, U.S. Food and Drug Administration
medicine.medical_treatment
ML, mechanical lithotripsy
Lithotripsy
Balloon
Extracorporeal
C-APCS, Comprehensive Ambulatory Payment Classification
03 medical and health sciences
0302 clinical medicine
Technology Status Evaluation Report
ES, endoscopic sphincterotomy
HCPCS, Healthcare Common Procedure Coding System
YAG, yttrium aluminum garnet
EHL, electrohydraulic lithotripsy
medicine
Radiology, Nuclear Medicine and imaging
RCT, randomized controlled trial
CPT, Current Procedural Terminology (https://www.asge.org/docs/default-source/education/Technology_Reviews/doc-enteral-nutrition-access-devices.pdf?sfvrsn=4)
EPBD, endoscopic papillary balloon dilation
Pancreatic duct
Endoscopic retrograde cholangiopancreatography
medicine.diagnostic_test
business.industry
Gastroenterology
MAUDE, Manufacturer and User Facility Device Experience
Extracorporeal shock wave lithotripsy
Laser lithotripsy
Surgery
medicine.anatomical_structure
030220 oncology & carcinogenesis
FREDDY, frequency-doubled, double-pulse neodymium
Balloon dilation
030211 gastroenterology & hepatology
CMS, Centers for Medicare and Medicaid Services
ASGE, American Society for Gastrointestinal Endoscopy
business
ERCP, endoscopic retrograde cholangiopancreatography
ESWL, extracorporeal shock wave lithotripsy
Subjects
Details
- ISSN :
- 24684481
- Volume :
- 3
- Database :
- OpenAIRE
- Journal :
- VideoGIE
- Accession number :
- edsair.doi.dedup.....9d5b16bb70b1cbdcfa4bc0230b9df046