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Optics and Photonics Journal 2013年第4期3卷 8-13页

作者： Hisanao Hazama Hiromu Kutsumi Kunio Awazu 1Graduate School of Engineering Osaka University Osaka Japan 2Graduate School of Frontier Biosciences Osaka University Osaka Japan 3The Center for Advanced Medical Engineering and Informatics Osaka University Osaka Japan Graduate School of Engineering Osaka University Osaka Japan Graduate School of Medicine Kobe University Kobe Japan

A novel technique of lithotripsy was investigated with a mid-infrared tunable pulsed laser using difference-frequency generation (DFG). Human gallstone samples obtained from 24 patients were analyzed with their infrared absorption spectra. It was found that the principal components of the gallstones were different for the different patients and that the gallstone samples used in this research could be classified into four groups, i.e., mixed stones, calcium bilirubinate stones, cholesterol stones, and calcium carbonate stones. In addition, some gallstone samples had different compositions within the single stone. The mid-infrared laser tunable within a wavelength range of 5.5 - 10 μm was irradiated to the cholesterol stones at two different wavelengths of 6.83 and 6.03 μm, where the cholesterol stones had relatively strong and weak absorption peaks, respectively. As the result, the cholesterol stones were more efficiently ablated at the wavelength of 6.83 μm with the strong absorption peak. Therefore, it is suggested that the gallstones could be efficiently ablated by tuning the wavelength of the laser to the strong absorption peak of the gallstones. The higher efficiency of the ablation using the characteristic absorption peaks should lead to the safer treatment without damage to the surrounding normal tissues. In order to identify the composition of the gallstones in the patients, endoscopic and spectroscopic diagnosis using the DFG laser and an optical fiber probe made with two hollow optical fibers and a diamond attenuation total reflection prism should be useful. The absorption spectrum of the gallstones in the patients could be measured by measuring the energy of the DFG laser transmitted through the optical fiber probe and by scanning the wavelength of the DFG laser.

关键词： Gallstone lithotripsy Mid-Infrared Tunable Laser Difference-Frequency Generation

Can Bladder Irrigation Reduce the Morbidity of Bladder Stone in Patients with Spinal Cord Injury?

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Open Journal of Urology 2015年第4期5卷 42-47页

作者： Hui Chen Keji Xie Chonghe Jiang Xinghua Yang Jingwen Zeng Maping Huang Qiuling Liu Jiebing Huang Tianhai Huang Yanfeng Li Jing Liu Shumei Xie Department of Urology Guangdong Provincial Work Injury Rehabilitation Hospital and Jinan University Guangzhou China Department of Urology Guangzhou First Municipal People’s Hospital Guangzhou China Department of Urology Qingyuan People’s Hospital Qingyuan China Department of Spinal Cord Injury Recovery center Guangdong Provincial Work Injury Rehabilitation Hospital Guangzhou China

Objective: To assess the safety and efficacy of bladder irrigation for reducing the morbidity of bladder stones in patients with neurological lower urinary tract dysfunction (NLUTD). Methods: From June 2012 to July 2013, patients with NLUTD were prospectively randomized and assigned to either a bladder irrigation group or a no bladder irrigation group. Bladder irrigations were performed twice a week by urologists. Patients were followed up at 6 months respectively. Primary outcomes were Incontinence-Specific Quality-of-Life Instrument (I-QoL), the rate incidences of bladder stone. All adverse events were also noted. Results: A total of 80 eligible patients participated and 78 (97.5%) patients (bladder irrigation, n = 39;no bladder irrigation, n = 39) completed 24 weeks of follow-up. Out of the 78 patients, 19 (24.3%) developed bladder stones. All occurred in no bladder irrigation group. In 8 of the 19 patients (42.1%), stones were only detected by cystoscopy. The bladder stones were mostly thin with an eggshell appearance (78.95% for diameter of stone lithotripsy (26.32%). The I-QOL was significantly better in the bladder irrigation group than in no bladder irrigation group at weeks 6, 12, 18, and 24 of follow-up. Conclusion: Bladder irrigation may be more effective and safer than no bladder irrigation for reducing the morbidity of bladder stone in spinal cord injury patients.

关键词： Bladder Irrigation Bladder Stone Spinal Cord Injury

Endoscopic extraction of large common bile duct stones:A review article

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World Journal of Gastrointestinal Endoscopy 2012年第5期4卷 167-179页

作者： Gerasimos Stefanidis Christos Christodoulou Spilios Manolakopoulos Ram Chuttani Department of Gastroenterology Athens Naval Hospital70 Deinokratous St115 21 AthensGreece 2nd Department of Internal Medicine Athens University Medical SchoolHippokration General Hospital of Athens114 Vas.Sophias Ave115 27 AthensGreece Division of Gastroenterology Beth Israel Deaconess Medical CenterHarvard Medical School330 Brookline AveBostonMA 02215United States

Since therapeutic endoscopic retrograde cholangiopancreatography replaced surgery as the first approach in cases of choledocolithiasis,a plethora of endoscopic techniques and devices appeared in order to facilitate rapid,safe and effective bile duct stones ***,endoscopic sphincterotomy combined with balloon catheters and/or baskets is the routine endoscopic technique for stone extraction in the great majority of *** common bile duct stones are treated conventionally with mechanical lithotripsy,while the most serious complication of the procedure is "basket and stone impaction" that is predominately resolved *** cases of difficult,impacted,multiple or intrahepatic stones,more sophisticated procedures have been *** lithotripsy and laser lithotripsy are performed using conventional mother-baby scope systems,ultra-thin cholangio-scopes,thin endoscopes and ultimately using the novel single use,single operator SpyGlass Direct Visualization System,in order to deliver intracorporeal shock wave energy to fragment the targeted stone,with very good ***,large balloon dilation after endoscopic sphincterotomy confirmed its effectiveness in the extraction of large stones in a plethora of *** compared with mechanical lithotripsy or with balloon dilation alone,it proved to be ***,dilation is an ideal alternative in cases of altered anatomy where access to the papilla is *** sphincterotomy followed by large balloon dilation represents the onset of a new era in large bile duct stone extraction and the management of "impaction" because it seems that is an effective,inexpensive,less traumatic,safe and easy method that does not require sophisticated apparatus and can be performed widely by skillful *** complete extraction of large stones is unsuccessful,the drainage of the common bile duct is mandatory either for bridging to the final therapy or as a curative therap

关键词： Large bile duct stones Endoscopic sphincterotomy Papillary balloon dilation Large papillary balloon dilation Mechanical lithotripsy Electrohydraulic lithotripsy Laser lithotripsy

Management of pancreaticobiliary disease using a new intra-ductal endoscope:The Texas experience

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World Journal of Gastroenterology 2009年第11期15卷 1353-1358页

作者： Douglas S Fishman Paul R Tarnasky Sandeep N Patel Isaac Raijman Texas Children’s Hospital Section of Pediatric Gastroenterology and NutritionBaylor College of Medicine6621 Fannin StreetHoustonTX 77030United States Digestive Health Associates Methodist Pavilion II 221 West Colorado Blvd.DallasTX 75208-2359United States Division of Gastroenterology and Nutrition The University of Texas Health Science Center at San Antonio7703 Floyd Curl Drive San AntonioTX 78229-3900United States Digestive Associates of Houston 6620 Main Street.HoustonTX 77030United States

AIM:To evaluate a new single-operator mini-endoscope, Spyglass,for its performance,feasibility and safety in the management of pancreaticobiliary disease. METHODS:In a multicenter retrospective analysis of patients undergoing intraductal endoscopy,we evaluated 128 patients(71 men,mean age 57.6 years).Indications were therapeutic(TX)in 72(56%) and diagnostic(DX)in 56(44%). RESULTS:Peroral endoscopy was performed in 121 and percutaneous in *** indications included CBD stones in 41,PD stones in six,and biliary strictures in *** indications included abnormal LFT’s in 15, abnormal imaging in 38 and cholangiocarcinoma staging in *** of the stone(s)was considered good in 31,fair in six,and poor in four. Advancement of the electrohydraulic lithotripsy probe was not possible in three patients and proper targeting of the lesion was partial in four patients.A holmium laser was used successfully in three *** clearance was achieved in 37 patients after one procedure and in four patients after two *** of biliary strictures was modified in 20/29 and confirmed to be malignant in 10/*** the modified patients,no diagnosis was available in *** demonstrated malignancy in 8/17 and non-malignancy in *** pathology by imaging studies and abnormal LFT’s was modified in 43/63(66%).Staging of cholangiocarcinoma demonstrated multicentric cholangiocarcinoma in 2/*** was no morbidity associated with the use of Spyglass. CONCLUSION:Spyglass Spyscopeis a first generation, single operator miniature endoscope that can evaluate and treat various biliary and pancreatic tract diseases.

关键词： Intra-ductal endoscopy Choledochoscopy Cholangiopancreatoscopy Endoscopic retrogradecholangiopancreatography Biliary disease Sclerosingcholangitis Cholangiocarcinoma lithotripsy Pancreaticdisease Spyglass

Impact of COVID-19 on endourology surgical practice in Saudi Arabia:A national multicenter study

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Asian Journal of Urology 2021年第4期8卷 416-423页

作者： Abdel Raheem Ali Yahya Ghazwani Ibrahim Alowidah Raed A.Azhar Mohammed Alomar Ahmed Alzahrani Ossamah Alsowayan Wissam Kamal Abdulrahman Alalayet Ahmad Bugis Abdulaziz MAlthunayan MAlzahrani Tarek Kamel Fadaak Aiman Al-Solumany Saeed Bin Hamri Urology Department King Saud Medical CityRiyadhSaudi Arabia Urology Department Faculty of MedicineTanta UniversityTantaEgypt Devision of Urology King Abdullah International Medical Research CenterCollege of MedicineKing Abdulaziz Medical CityKing Saud Bin Abdulaziz University for Health ScienceDivision of UrologyKing Abdulaziz Medical CityRiyadhSaudi Arabia Urology Department Faculty of MedicineKing Abdulaziz UniversityJeddahSaudi Arabia Department of Surgery College of MedicineKing Saud University and King Saud University Medical CityRiyadhSaudi Arabia Urology Department Price Sultan Military Medical CityRiyadhSaudi Arabia Urology Department King Fahd HospitalImam Abdulrahman Bin Faisal UniversityDammamSaudi Arabia Urology Department King Fahd HospitalJeddahSaudi Arabia

Objective:To identify the impact of COVID-19 on endourology surgical practice in Saudi ***:A retrospective study of seven tertiary hospitals from January 2019 to April 2019,and from January 2020 to April 2020 was *** of urology outpatient department(OPD)visits and endourology procedures in the first third of 2020 were analyzed and compared with those in the first third of 2019,as well as,during the full curfew time,*** 2020 versus April ***:Number of OPD visits in the first third of 2020 and 2019 were 19499 and 26594,respectively(pshockwave lithotripsy,and transurethral resection of prostate procedures declined by 94.2%,98.5%,and 93.8%,*** procedures were performed as day surgery(85.0%).Number of emergency procedures in 2020 have fallen by 9.3%compared to 2019(pZ0.286).Urolithiasis was the commonest pathology(52.6%)presented to the emergency room(52.6%).Conclusion:During COVID-19 pandemic,urology services slashed by>75%,including OPD visits and elective endourology *** hospitals have changed their strategic preventive measures by increasing the rate of teleclinics and day surgeries.

关键词： COVID-19 Endourology Saudi Arabia

Peroral cholangioscopy:Update on the state-of-the-art

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World Journal of Gastrointestinal Endoscopy 2022年第2期14卷 63-76页

作者： Amith Subhash James L Buxbaum James H Tabibian Department of Gastroenterology Kirk Kerkorian School of Medicine at UNLVLas VegasNV 89102United States Division of Gastrointestinal and Liver Diseases Keck School of Medicine of USCLos AngelesNV 90033United States David Geffen School of Medicine at UCLA Division of GastroenterologyDepartment of MedicineOlive View-UCLA Medical CenterSylmarCA 91342United States Vatche and Tamar Manoukian Division of Digestive Diseases David Geffen School of Medicine at UCLALos AngelesNV 90095United States

Peroral cholangioscopy(POC)is an endoscopic procedure that allows direct intraductal visualization of the biliary *** has emerged as a vital tool for indeterminate biliary stricture evaluation and treatment of difficult biliary *** several generations of devices,POC has fulfilled additional clinical needs where other diagnostic or therapeutic modalities have been *** adverse event rates comparable to standard endoscopic retrograde cholangioscopy and unique technical attributes,the role of POC is likely to continue *** this frontiers article,we highlight the existing and growing clinical applications of POC as well as areas of ongoing research.

关键词： Peroral cholangioscopy SpyGlass^(TM) Difficult bile duct stones Indeterminate biliary strictures Cholangioscope-guided biopsy Cholangioscope-guided lithotripsy