Category: Other, Miscellaneous
VS5-1 - New surgical technique applied with urological instruments in multiple hepatolithiasis: Ultra-mini percutaneous hepatolithotomy (First three cases)
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.
- MS
Mehmet Giray Sönmez
– Department of Urology, Necmettin Erbakan University, Meram Medical Faculty,, Konya, Konya, Turkey - AÃ
Ahmet Öztürk
– Department of Urology, Necmettin Erbakan University, Meram Medical Faculty, Konya, Turkey., Konya, Konya, Turkey - SB
Süleyman Bakdık
– Department of Radiology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey., Konya, Konya, Turkey - GE
Gökhan Ecer
РBuckshot Centered Nucleous- Matrix Ureterolithiasis Due To Gunshot Injury., Konya, Konya, Turkey 
Yunus Göger
– Asis. Prof., Necmettin Erbakan University Meram Medical Faculty Department of Urology, Konya, Konya, Turkey- SÃ
Serkan Özkent
– Department of Urology, Necmettin Erbakan University, Meram Medical Faculty, Konya, Turkey, Konya, Konya, Turkey - FA
Faruk Aksoy
– Department of General Surgery, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey., Konya, Konya, Turkey - MB
Metin Belviranlı
– Department of General Surgery, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey., konya, Konya, Turkey