Novosti
Khirurgii
This journal is
indexed in Scopus



Year 2013 Vol. 21 No 2

GENERAL AND SPECIAL SURGERY

DOI: http://dx.doi.org/10.18484/2305-0047.2013.2.45   |  

S.V. ALEXANDROV 1,2

POSSIBILITIES OF ENDOSCOPIC LASER LITHOTRIPSY IN PATIENTS WITH CHOLANGIOLITHIASIS

SEE Belarusian Medical Academy of Post-Graduate Education1,
ME Minsk Regional Clinical Hospital2,
The Republic of Belarus

Objectives. To determine the wave length of laser radiation with the most marked lithotripsy effect concerning the concretions of the extrahepatic bile ducts as well as to find out the optimal parameters of laser radiation to carry out lithotripsy.
Methods. Affecting the concretions of the extrahepatic bile ducts by laser radiation of 1064, 1320 and 1440 nm wavelengths in liquid medium we have ascertained the wavelength with most expressed effect of lithotripsy. Then, changing stepwise the energy of the laser radiation impulse of 1320 and 1440 nm wavelengths we have determined the optimal values of the impulse energy to carry out lithotripsy.
Results. The largest size of the concretion could be destroyed by a single impulse of 1440 nm wavelength of laser radiation at the same parameters.
The minimal lithotripsy effect is found at 1064 nm wavelength. The optimal values of the impulse energy for the performance of extrahepatic bile duct concretions lithotripsy by 1320 nm wavelength radiation are considered to be within the limits of 0.9-1,5 J and 0,5-0,8 J for 1440 nm. Higher values of the impulse energy are considered as dangerous for application in connection with impossibility to control distinctly the process of concretion destruction and damage risk of the adjacent tissues.
Conclusions. A 1440 nm wavelength radiation has the greatest effect of lithotripsy out of three wavelengths (1064, 1320 and 1440 nm) and is considered the most safe and effective for lithotripsy performance at cholangiolithiasis. 1320 nm wavelength radiation can be also applied to destroy large concretions of the extrahepatic bile ducts at laparoscopic and videoendoscopic interventions.

Keywords: cholelithiasis, cholangiolithiasis, laser lithotripsy
p. 45 53 of the original issue
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Address for correspondence:
223052, Respublika Belarus', Minskaia oblast', Minskii raion, p. Lesnoi-1; UZ Minskaia oblastnaia klinicheskaia bol'nitsa, khirurgicheskoe otdelenie 2,
e-mail: dr_Alexandrov@tut.by,
Aleksandrov Sergei Vladimirovich
Information about the authors:
Alexandrov S.V. A head of the surgical department 2 of ME Minsk regional clinical hospital, lecturer of the surgery chair of SEE Belarusian Medical Academy of Post-Graduate Education.
Contacts | ©Vitebsk State Medical University, 2007