Contact lithotripsy under control of oral cholangioscopy in treatment of "difficult" choledocholithiasis in elderly patients

Introduction.The tactics of treating patients with large calculi in the bile ducts are not clearly defined. The methods of their removal and the results of treatment depend on the equipment and the treatment tactics accepted in the hospital. Main. To improve the results of treatment of patients with «difficult» choledocholithiasis in senile patients. Materials and methods. An analysis of the treatment results of 4 patients who underwent contact laser lithotripsy using the direct oral cholangioscopy system for choledocholithiasis Results. The use of contact lithotripsy under the control of the spy glass system made it possible to fragment large calculi (more than 1.5 cm) and remove from bile ducts in 4 patients. Moreover, in only one case, postoperative transient hyperamylasemia was noted. No significant postoperative complications were identified. The terms of the postoperative period did not exceed 8 days. Conclusion. The use of contact lithotripsy allowed the use of low-invasive, minimally invasive and highly effective treatment methods with good immediate results, in the absence of significant postoperative complications.