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Treatment of urinary lithiasis following kidney transplantation with extracorporeal shock-wave lithotripsy

Chinese Medical Journal 2011年第9期124卷 1431-1434页

作者： LI Sha-dan WANG Qing-tang CHEN Wei-guo Department of Urology General Hospital of Chengdu Military Command Chengdu Sichuan 610083 China

Background The incidence of urinary lithiasis following kidney transplantation is very low, and decision-supporting data are not available. The aim of this study was to review the diagnosis and treatment of urinary lithiasis following kidney transplantation, which is of realistic significance to reduce urinary lithiasis following kidney transplantation, prolong the survival of renal allografts.Methods The incidence, diagnosis and treatment of urinary lithiasis in ten patients following kidney transplantation were analyzed retrospectively. Seven out of these patients had stones sized approximately 0.4-1.1 cm, and they were treated with low-voltage, low-frequency extracorporeal shock-wave lithotripsy （ESWL）. Two patients had stones sized ＜0.3 cm and they underwent cystoscopy and ureteroscopy. The ureteral catheter endoscopes were inserted in a retrograde manner to mobilize stones repeatedly. After elimination of obstruction, a ureteral double J stent was indwelt.One patient had a pelvic stone （1.2 cm）, which was removed surgically.Results The major clinical manifestations were hematuria, oliguria or anuria. Some patients were asymptomatic and they were diagnosed through laboratory tests and imaging examinations, e.g., ultrasonography. After elimination of obstruction, subjective symptoms disappeared in all patients, and the function of renal allografts recovered. A six-month follow-up indicated no remnant stones or lithiasis relapse.Conclusions The diagnosis and treatment of renal allograft lithiasis are challenging. After prompt and appropriate treatment, the prognosis was satisfactory, and permanent renal functional impairment did not occur in most patients.

关键词： kidney transplantation lithiasis extracorporeal shock-wave lithotripsy

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PROGRESS OF SURGICAL TREATMENT OF INTRAHEPATIC lithiasis IN CHINA

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Chinese Medical Journal 1996年第7期 11-14页

作者：黄志强

ＰＲＯＧＲＥＳＳＯＦＳＵＲＧＩＣＡＬＴＲＥＡＴＭＥＮＴＯＦＩＮＴＲＡＨＥＰＡＴＩＣＬＩＴＨＩＡＳＩＳＩＮＣＨＩＮＡＨｕａｎｇＺｈｉｑｉａｎｇ黄志强ＤｅｐａｒｔｍｅｎｔｏｆＳｕｒｇｅｒｙ，ｔｈｅＧｅｎｅｒａｌＨｏｓｐｉ... 详细信息

ＰＲＯＧＲＥＳＳＯＦＳＵＲＧＩＣＡＬＴＲＥＡＴＭＥＮＴＯＦＩＮＴＲＡＨＥＰＡＴＩＣＬＩＴＨＩＡＳＩＳＩＮＣＨＩＮＡＨｕａｎｇＺｈｉｑｉａｎｇ黄志强ＤｅｐａｒｔｍｅｎｔｏｆＳｕｒｇｅｒｙ，ｔｈｅＧｅｎｅｒａｌＨｏｓｐｉｔａｌｏｆＣｈｉｎｅｓｅＰＬＡ，Ｂ...

关键词：黄志强 INTRAHEPATIC lithiasis OF PROGRESS SURGICAL TREATMENT CHINA

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The lithiasis of Choledoque: Epidemiological Aspects, Clinics and Therapeutiques in the Surgery Department “A” at the University Hospital Point G

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Surgical Science 2019年第8期10卷 281-286页

作者： O. Sacko S. Diallo L. Soumaré M. Camara S. Koumaré M. Sissoko S. Keita I. Diarra M. Konaté M. Traoré G. Soumaré D. Dakouo M. Coulibaly H. Dicko Y. Dianessi A. Koita Z. Sanogo Department of Surgery “A” University Hospital of Point G Bamako Mali Department of Surgery “B” University Hospital of Point G Bamako Mali Department of Surgery Reference Center of Town 6 Bamako Mali Department of Gynecology-Obstetrics University Hospital of Point G Bamako Mali Department of Intensive Care University Hospital of Point G Bamako Mali

Considered as rare in Africa lithiasis of the main bile duct (MBD) is a potentially serious pathology, diagnosis is facilitated by imaging tests (ultra-sound, CT, MRI cholangiopancreatography). Its surgical management is improved by laparoscopy coupled with interventional endoscopy. However, laparotomy remains the only way in Mali. This was a 14-years retrospective and descriptive study (2010-2014). All patients with BPV lithiasis were included. We studied the field, antecedents, clinical, biological, radiological, therapeutic and outcome aspects. 40 cases of stones in the main bile duct were collected during the study period. The hospital frequency was 2.8 cases per year, the clinical signs dominated by the Charcot triad (pain, fever, jaundice) found in 40 cases (100%). The average age was 60 years, female represented 70% of cases. Ultrasonography was the most requested review in 40 cases (100%). The procedure performed was cholecystectomy associated with choledochotomy with calculation extraction in all patients (100% of cases). One case of biliary fistula and one case of wall abscess were observed. The mortality was 5% and the simple suited in 90% of the cases. The lithiasis of the main bile duct is an infrequent pathology in Mali and potentially serious. This diagnosis is assisted in our context by ultrasound and CT. Laparotomy remains the only route of entry in Mali.

关键词： lithiasis of the CBD Surgery Cholodochotomy

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Diverticular Fistula of the Female Urethra on lithiasis at the District Health Center (CSREF) in Communeii, Bamako, Mali

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Surgical Science 2019年第3期10卷 83-88页

作者： Tounkara Idrissa Diarra Abdoulaye Traoré Amadou Coulibaly B. Bakary Kanté Abdoulaye Dembélé Dabéré Ives Thiam Souleymane Ouattara Kassoum Kanté Lassana Konate Madiassa Koné Assitan Ongoiba Oumar Sangaré Modibo Dembélé Bakary Tiètiki Diakité Ibrahim Sidibé Yoro Bah Amadou Coulibaly Yakaria Togo Adégné Diallo Gangaly Chirurgie générale du Centre de santé de référence de la commune II de Bamako Mali Chirurgie générale du Centre Hospitalier Universitaire de Kati Mali Chirurgie générale Centre Hospitalier Universitaire Gabriel TOURE de Bamako Mali Chirurgie générale du Centre Hospitalier Universitaire du POINT G de Bamako Mali Hopital régional de Gao Mali Hopital régional de Tombouctou Mali

The diverticulum of the female urethra or sub-urethral pouch is in the form of a cul-de-sac lined with mucous membrane through the muscular layer of the urethra. Thus, it is a site of stasis, urinary infection, formation of calculus or even malignant tumor. The diverticula of the urethra or sub-urethral pouches in women have a prevalence of 0.5% to 6% depending on the series. We report the case of a 61-year-old patient operated for a diverticulum on fistulized urethra complicated lithiasis. Our patient had five pregnancies and five births when she consulted for dysuria, urinary burns evolving since a year. The urogenital examination revealed a partially stenotic urethral meatus and a 3-cm large fistulized intravaginal peri-urethral mass allowing urine leak. The mass was painful and hard at palpation. We performed transvaginal diverticulectomy. The follow-up was simple and the probe was removed two weeks after the surgery. An atomo-pathological examination of the resected diverticulum concluded an aspect compatible with lithiasis urethritis.

关键词： Diverticulum Urethral Fistula lithiasis Bamako

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Impact of the adherence to medical treatment on the main urinary metabolic disorders in patients with kidney stones

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Asian Journal of Urology 2021年第3期8卷 275-279页

作者： Braulio Omar Manzo Jose David Cabrera Esteban Emiliani Hector Manuel Sanchez Brian Howard Eisner Jose Ernesto Torres Urology Department Hospital Regional de Alta Especialidad del BajioBlvd.Milenio#130Col.San Carlos la RonchaLeonGuanajuatoMexico Urology Department Fundacion PuigvertUniversidad Autonoma de BarcelonaBarcelonaSpain Urology Department Massachusetts General HospitalHarvard Medical SchoolBostonUSA

Objective:To assess the effect of the adherence to medical treatment on urinary parameters in the 24-h metabolic study of patients with kidney stones.Methods:A retrospective,longitudinal,descriptive,and observational study was carried out by reviewing the hospital electronic medical record from 2014 to 2018.The adherence to drug treatment was measured 6 months after its initiation,and the numerical values of the metabolic studies were compared.Wilcoxon tests were performed to compare the difference before and after treatment.Results:Ninety patients were evaluated,with 73.3% of adherence.The 180-day overall adherence rate was 61.2% in patients treated with a single drug and 85.4% in patients treated with multiple drugs.There is a statistically significant increase in citrate levels in patients with good adherence in comparison with non-adherent patients(p=0.031 vs.p=0.528).Conclusions:Medical treatment and dietary measures in patients with kidney stones have an initial impact at 6 months on the values of the main urinary metabolic alterations that predispose to calculi formation;the most significant is seen in those patients with adherence to medical treatment for hypocitraturia.

关键词： Kidney stones Renal stones Metabolic disorders Medical treatment Citrate Oxalate lithiasis

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Laparoscopic Cholecystectomy at the Centre Hospitalier Universitaire (CHU) Mère-Enfant le “Luxembourg” in Mali for 2 Years from 2020 to 2021

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Surgical Science 2022年第12期13卷 585-591页

作者： Amara Coulibaly Abdoul Karim Simaga Moussa Sissoko Sekou Koumaré Mamedy Doumbia Sidiki Konaré Zimogo Zie Sanogo Surgical Department “A” of the University Hospital Center (CHU) of Point-G Bamako Mali Surgical Department of the Centre Hospitalier Universitaire Mère-Enfant (CHU-ME) le “Luxembourg” Bamako Mali

Introduction: Laparoscopic cholecystectomy is a surgical technique that involves the removal of the gallbladder by laparoscopy. Its practice is timid in sub-Saharan Africa, despite the existence of risk factors such as sickle cell disease. We report our 2-year experience of laparoscopic cholecystectomy in the general surgery department of the CHU-ME Luxembourg. Materials and Method: This was a descriptive cross-sectional study from September 2019 to September 2021. The study included 64 patients with vesicular lithiasis who underwent laparoscopic cholecystectomy. Data were analyzed on SPSS software (version 25.0). Confidentiality and anonymity of the subjects were respected. Results: The frequency of cholecystectomy was 30.9%. The average age was 38.37 ± 16.94 years. The female sex was 70.3%. Obesity and sickle cell disease were found in 85.9% and 14.1% of patients. On physical examination, hepatic colic was found in 54.7% and the Murphy sign was positive in 64.1% of patients. Ultrasound diagnosis of vesicular lithiasis was made in all patients. All patients underwent laparoscopic cholecystectomy, which was retrograde in 64.1% of cases. The average procedure time was 66 minutes. No case of complication was recorded postoperatively. Conclusion: Laparoscopic cholecystectomy is a technique to be developed and supported.

关键词： Cholecystectomy Laparoscopic lithiasis Mali

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Left Pyelic Bifidity and Ectopic Ureteral Superolateral Intravesical Homolateral Ectopic Junction Revealed by a Urinary Calculus Apropos of a Case at the Pasteur Clinic

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Open Journal of Medical Imaging 2022年第3期12卷 123-130页

作者： Abdoulaye Kone Oucoumba Diarra Mamoudou Camara Youssouf Kone Abba Ata Omar Moussa Traore Ibrahima Coulibaly Moussa Konate Kassim Sidibe Toumin Camara Youssouf Diawara Cheick Oumar Toure Abdoulaye Mody Camara Salia Coulibaly Mahamadou Diallo Adama Diaman Keita Aboubacar S. Ndiaye Siaka Sidibe Faculty of Medicine and Odontostomatology Bamako Mali Medical Imaging Department of the University Hospital of Point G Bamako Mali Radiology Department of CSREF Commune III Bamako Mali Medical Imaging Service Mother Child Hospital Luxembourg Bamako Mali FSTS Gamal Abdel NasserConakry Guinea Radiology Department of the Jacques Boutard Hospital Saint-Yrieix-la-Perche France France Medical Imaging Department of the Pasteur Polyclinic Bamko Mali DCSSA Bamako Mali General Medicine Department of the Siguiri Prefectural Hospital Siguiri Guinea Medical Imaging Service Health Center of Ref Commune IV Bamako Mali Medical Imaging Department of Mali Hospital Bamako Mali Medical Imaging Department of KATI Hospital Bamako Mali Medical Imaging Department of GABRIEL TOURE Hospital Bamako Mali

Introduction: Malformations of the excretory tract are abnormalities due to a disorder of embryogenesis. According to some authors, their frequency varies from 0.30 to 5.25 per 1000. The aim of this study was to highlight the CT uroscan aspect of pyelic bifidity with intravesical ureteral ectopic junction revealed by a urinary calculus and to explain the interest of CT uroscan in the management of urinary pathologies. Result: We report the observation of a 37-year-old overweight patient with a body mass index equal to 28, a history of surgery and extracorporeal litho-thipsis dating back 10 years. He was referred to the Imaging Department in the context of renal colic. The uroscanner made it possible to highlight a left pyelic bifidity associated with an ectopic abutment of the left ureter on the superolateral wall of the bladder, a calculation in the left ectopic ureteral meatus measured at 4 mm in axial diameter. He noted upstream of these lesions, a uretero-pyelo-calicielle dilation on double homolateral pyelon. On late cuts, a slight delay in left renal excretion was noted. The right kidney was also the site of a hyperdense calculation of 1257 HU density and measured 4 mm in transverse diameter with a non-obstructive appearance. Due to a lack of means, our patient was subjected to oral medication, hygiene and dietary rules and rigorous monitoring. Conclusion: At the end of this study, the uroscanner is presented as the reference examination to better explore urinary pathologies. At the same time, it makes it possible to carry out a study of the organs surrounding the urinary tract. Always think about the association of several urinary pathologies each time you see a patient for renal colic.

关键词： Bifidity Pyelic Uroscanner Ectopia lithiasis

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Minimally invasive treatment of cholecysto-choledocal lithiasis:The point of view of the surgical endoscopist

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World Journal of Gastrointestinal Surgery 2013年第6期5卷 161-166页

作者： Giovanni D De Palma Center of Excellence for Technical Innovation in Surgery Department of Clinical Medicine and SurgerySchool of MedicineUniversity of Naples Federico Ⅱ80131 NapoliItaly

The rate of choledocholithiasis in patients with symptomatic cholelithiasis is estimated to be approximately 10%-33%,depending on the patient's age.Development of Endoscopic Retrograde Cholangiopancreatography and Laparoscopic Surgery and improvement of diagnostic procedures have influenced new approaches to the management of common bile duct stones in association with gallstones.At present available minimally-invasive treatments of cholecysto-choledocal lithiasis include:single-stage laparoscopic treatment,perioperative endoscopic treatment and endoscopic treatment alone.Published data evidence that,associated endoscopic-laparoscopic approach necessitates increased number of procedures per patient while single-stage laparoscopic treatment is associated with a shorter hospital stay.However,current data does not suggest clear superiority of any one approach with regard to success,mortality,morbidity and cost-effectiveness.Considering the variety of therapeutic options available for management,a critical appraisal and decision-making is required.endoscopic retrograde cholangiopancreatography/EST should be adopted on a selective basis,i.e.,in patients with acute obstructive suppurative cholangitis,severe biliary pancreatitis,ampullary stone impaction or severe comorbidity.In a setting where all facilities are available,decision in the selection of the therapeutic option depends on the patients,the number and size of choledocholithiasis stones,the anatomy of the cystic duct and common bile duct,the surgical history of patients and local expertise.

关键词： Cholecysto-choledocal lithiasis Laparoscopic treatment Endoscopic treatment Minimally invasive therapy Management strategies

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Chemical cholecystectomy

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World Journal of Gastroenterology 1998年第S1期4卷 41-43页

ＩＮＴＲＯＤＵＣＴＩＯＮＣｈｏｌｅｌｉｔｈｉａｓｉｓｉｓａｃｏｍｍｏｎｌｙｅｎｃｏｕｎｔｅｒｅｄｄｉｓｅａｓｅｉｎＣｈｉｎａ．Ｉｔｗａｓｒｅｐｏｒｔｅｄｔｈａｔｔｈｅｉｎｃｉｄｅｎｃｅｒａｔｅｉｓ７％ｂｙａｕｔｏｐｓ... 详细信息

ＩＮＴＲＯＤＵＣＴＩＯＮＣｈｏｌｅｌｉｔｈｉａｓｉｓｉｓａｃｏｍｍｏｎｌｙｅｎｃｏｕｎｔｅｒｅｄｄｉｓｅａｓｅｉｎＣｈｉｎａ．Ｉｔｗａｓｒｅｐｏｒｔｅｄｔｈａｔｔｈｅｉｎｃｉｄｅｎｃｅｒａｔｅｉｓ７％ｂｙａｕｔｏｐｓｙ．Ｒｅｃｅｎｔｉｎｖｅｓｔｉｇａ...

关键词： cholelithiasis/therapy chole lithiasis /surgery chemical chemical cholecysto stomy cholecystostomy lithotomy

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Diagnosis and management of choledocholithiasis in the golden age of imaging, endoscopy and laparoscopy

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World Journal of Gastroenterology 2014年第37期20卷 13382-13401页

作者： Renato Costi Alessandro Gnocchi Francesco Di Mario Leopoldo Sarli Dipartimento di Scienze Chirurgiche Università di ParmaAzienda Ospedaliero-Universitaria di Parma Dipartimento Materno Infantile Unità Operativa di Gastroenterologia ed Endoscopia DigestivaAzienda Ospedaliero-Universitaria di Parma Dipartimento di Medicina Clinica e Sperimentale Università di ParmaAzienda Ospedaliero-Universitaria di Parma

Biliary lithiasis is an endemic condition in both Western and Eastern countries, in some studies affecting 20% of the general population. In up to 20% of cases, gallbladder stones are associated with common bile duct stones(CBDS), which are asymptomatic in up to one half of cases. Despite the wide variety of examinations and techniques available nowadays, two main open issues remain without a clear answer: how to cost-effectively diagnose CBDS and, when they are finally found, how to deal with them. CBDS diagnosis and management has radically changed over the last 30 years, following the dramatic diffusion of imaging, including endoscopic ultrasound(EUS) and magnetic resonance cholangiography(MRC), endoscopy and laparoscopy. Since accuracy, invasiveness, potential therapeutic use and costeffectiveness of imaging techniques used to identifyCBDS increase together in a parallel way, the concept of "risk of carrying CBDS" has become pivotal to identifying the most appropriate management of a specific patient in order to avoid the risk of "under-studying" by poor diagnostic work up or "over-studying" by excessively invasive examinations. The risk of carrying CBDS is deduced by symptoms, liver/pancreas serology and ultrasound. "Low risk" patients do not require further examination before laparoscopic cholecystectomy. Two main "philosophical approaches" face each other for patients with an "intermediate to high risk" of carrying CBDS: on one hand, the "laparoscopy-first" approach, which mainly relies on intraoperative cholangiography for diagnosis and laparoscopic common bile duct exploration for treatment, and, on the other hand, the "endoscopy-first" attitude, variously referring to MRC, EUS and/or endoscopic retrograde cholangiography for diagnosis and endoscopic sphincterotomy for management. Concerning CBDS diagnosis, intraoperative cholangiography, EUS and MRC are reported to have similar results. Regarding management, the recent literature seems to show better short and long term outcome of surgery in terms of re

关键词： Biliary lithiasis Choledocholithiasis Laparoscopy

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