How to Prevent and Cope with Stone Incarceration in Choledochoscope

How to Prevent and Cope with Stone Incarceration in Choledochoscope?

17 stone incarceration cases were treated in Second Affiliated Hospital of Nanjing Medical University without serious complications such pancreatitis or perforation. They are 3 cases stone incarceration in sious, 9 cases in intrahepatic bile duct, and 5 cases in papilla.

How to Prevent and Cope with Stone Incarceration in Choledochoscope?

Identify the stone size by radiography before you start the operation.

Use lithotripter for large stone before using basket to prevent stone incarceration.

Once the stone incarceration happens, follow the below measures to cope with the urgent situation.

1. Rotate and take away the screw cap on the tail of the handle.

2. Retreat the outer sheath and choledochoscope.

3. Insert the choledochoscope through the inner wire until the position of stone incarceration could be observed clearly in the vision.

4. Through the working channel of choledochoscope the laser fiber is inserted close to the stone.

5. Make laser radiation at the center of the stone at 120mJ pulse energy. Adjust the position of laser radiation until the stone is broken into small pieces.

6. Use basket to take out small stones.