Usefulness of Spy-Glass™ DS-guided electronic hydraulic lithotripsy

Abstract

Lithotripsy treatment using Spy-Glass™ DS (Spy-DS)-guided electronic hydraulic lithotripsy (EHL) is useful for difficult bile duct stones to remove such as giant piled stones and intrahepatic stones. Since 2017, we have been treating stones under the Spy-DS. Fourteen patients (8 cases of common bile duct stones and 6 cases of intrahepatic stones) who had undergone Spy-DS-guided EHL for difficult bile duct stones were retrospectively examined since October 2017 to September 2020. The main outcomes were the treatment results (the rate of complete stone removal and total procedure time to complete) and adverse events. The rate of complete stone removal was 100%. The median total procedure time for common bile duct was 72.5 (8-141) minutes, and that for intrahepatic stones was 69.5 (5-138) minutes. The median number of endoscopic sessions for the common bile duct was 2.5 (2-4) times, and that for intrahepatic stones was 2 (1-3) times. Although there was one adverse event after endoscopic large-diameter nipple dilatation (EPLBD), it improved conservatively. The Spy-DS-guided EHL appears useful for complete stone removal of difficult bile duct stones.