TY - JOUR T1 - New management of hepatolithiasis: Can surgery be avoided? (with video) JO - Gastroenterología y Hepatología T2 - AU - Mansilla-Vivar,Rodrigo AU - Alonso-Lázaro,Noelia AU - Argüello-Viudez,Lidia AU - Ponce-Romero,Marta AU - Bustamante-Balen,Marco AU - Pons-Beltrán,Vicente SN - 02105705 M3 - 10.1016/j.gastrohep.2019.11.008 DO - 10.1016/j.gastrohep.2019.11.008 UR - https://www.elsevier.es/es-revista-gastroenterologia-hepatologia-14-articulo-new-management-hepatolithiasis-can-surgery-S0210570520300182 AB - BackgroundThe presence of hepatolithiasis (HL) is prevalent in eastern countries. It is a clinical entity which is rarely reported in non-surgical series because the standard treatment is the surgical option. Currently, treatment has evolved, with the use of endoscopic techniques being increased and the number of hepatectomies being decreased.SpyGlass™ is a small-calibre endoscopic direct cholangiopancreatoscopy developed to explore and perform procedures in the bile and pancreatic ducts. Single-operator peroral cholangioscopy (POC) is an endoscopic technique useful for treating difficult bile duct stones. AimsTo assess the usefulness, efficacy, and safety of POC with the SpyGlass™ system in patients with HL. Primary objectives: to achieve technical success of the procedure and clinical success of patients with HL. Study design and patientsRetrospective, single-centre cohort study of patients with HL from April 2012 to August 2018. SpyGlass™ was chosen in symptomatic patients referred from the surgery unit as the first-line procedure. To perform electrohydraulic lithotripsy (EHL), we used a Northgate Autolith IEHL generator with a 0.66-mm biliary probe. ResultsWe performed a total of 13 procedures in 7 patients with HL. The mean age was 46 years (range 35–65) and 3/7 of patients were female. We achieved technical success in 5/7 cases (71.4%) and clinical success in 4/7 cases (57%). DiscussionSpyGlass™ is safe and effective in the treatment of HL. With these results, we confirm the need for management of patients with HL in a multidisciplinary team. When the endoscopic approach is the option, this procedure must be performed by experts in advanced endoscopy. ER -