Category: Other, Miscellaneous

VS5-1 - New surgical technique applied with urological instruments in multiple hepatolithiasis: Ultra-mini percutaneous hepatolithotomy (First three cases)

Fri, Sep 21
2:00 PM - 4:00 PM

Introduction & Objective : We present the Ultra-Mini Percutaneous Hepatolithotomy (UM-PHL) experience we had through minimal dilatation with minimal invasive tools (urological instruments) in three patients who had multiple surgery many times due to gall ducts stones.


Methods :

Cases Presentation:


First patient: Twenty three years old female patient had portoenterostomy and cholecystectomy operation when she was two months old due to choledoch cyst , There were stones in the intrahepatic bile ducts of the patient who had recurrent cholangeitis and pancreatitis attacks ,Open choledoch cyst resection and wirsung jejunostomy operations were made a year ago due to the continuing complaints of the patient , Previous treatments failed due to high stone load.


Second patient: Thirty nine years old male patient He has ERCP and MRCP procedure  because of distal choledoc  stone(21mm) ten years ago. He has also cholecystectomy  and choledochoduodenostomy   operations  after ERCP/MRCP. He applied hospital with stomacache and jaundice. He was made percutanous transhepatic cholangiography and ERCP.


Third Patient: A seventy seven years old male patient , He has cholesistectomy story because of cholelithiasis four years ago. In last three years,  many times ERCP and percutaneous  drainage catheter procedure made. A year ago he has been operated Roux-en-Y  choledochojejunostomy  


Surgical Tecnique:  Details of the surgical technique are described in the video.


 


 


Results : All of the stones in the  three patient’ s intrahepatic bile ducts were removed (stone-free).  The patients didn't have any problems in the postoperative follow-ups. The third or fourth day after the procedure, the drains were taken and the patient was discharged on the third or fourth day.


Conclusions :  In hepatolithiasis patients with high stone load, it is a safe and successful method to clean the stones by providing minimal dilatation through percutaneous intervention regardless of the surgical story in bile ducts and using instruments with a small diameter and pneumatic lithotriptor.  We think that UM-PHL procedure done by surgeons who have years of experience in percutaneous nephrolithotomy field and are skilled in percutaneous surgery would decrease stone-free state and morbidity ratios and increase surgical success.

Mehmet Giray Sönmez

Department of Urology, Necmettin Erbakan University, Meram Medical Faculty,
Konya, Konya, Turkey

Ahmet Öztürk

Department of Urology, Necmettin Erbakan University, Meram Medical Faculty, Konya, Turkey.
Konya, Konya, Turkey

Süleyman Bakdık

Department of Radiology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey.
Konya, Konya, Turkey

Gökhan Ecer

Buckshot Centered Nucleous- Matrix Ureterolithiasis Due To Gunshot Injury.
Konya, Konya, Turkey

Yunus EMRE. Göger

Asis. Prof.
Necmettin Erbakan University Meram Medical Faculty Department of Urology
Konya, Konya, Turkey

Name-Surname : Yunus Emre GÖGER
Birth place and Date: Konya–20. 04. 1981
Marital status: Married
Home Address : Küçükihsaniye Mah. Şehit Ömer Taşer sok. Oda kent sitesi 13/14 Selçuklu/Konya
Cell Phone: 05334150753
E-mail: dr_yegoger@yahoo.com

EDUCATİONAL INFORMATION:

Primary School: Mümtaz Koru Primary School /1987–1991(Konya)
High School: Konya Selçuk Anatolian High School / 1999 (Konya)
University: Konya SelcukUniversity Meram Medical Faculty / TURKEY 1999–2005
Urology Speciality: Necmettin Erbakan University Meram Medical Faculty Urology Department /TURKEY 2007–2013
Asst. Prof. : Necmettin Erbakan University Meram Medikal Faculty Urology Department / TURKEY 2016-
Fellow of the European Board of Urology (FEBU): 3 June 2017

WORKING HISTORY
Practicing Physician: Konya Hüyük Sağlık Ocağı / TURKEY 2005/2007
MD., Necmettin Erbakan University Meram Medical Faculty Urology Department /TURKEY 2007–2013
Urologist:Batman District State Hospital / TURKEY 2013-2014
Urologist: Konya Education and Research Hospital /TURKEY 2014-2016
Asst. Prof. : Necmettin Erbakan University Meram Medikal Faculty Urology Urology Department / TURKEY 2016-

Serkan Özkent

Department of Urology, Necmettin Erbakan University, Meram Medical Faculty, Konya, Turkey
Konya, Konya, Turkey

Faruk Aksoy

Department of General Surgery, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey.
Konya, Konya, Turkey

Metin Belviranlı

Department of General Surgery, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey.
konya, Konya, Turkey