How big is the largest stone

Stones are a common disease in clinical medicine. Kidney stones, gallstones, dental stones and urethral stones are all stones, and they are all diseases that can have a great impact on the patient's health. Of course, the larger the stone, the greater the impact it will have on the patient, and it will require more direct and effective treatment methods. Below, I will introduce to you several methods that can effectively treat large stones!

1. Minimally invasive gallbladder preservation and lithotomy

The new fiber choledochoscope minimally invasive gallbladder preservation and lithotomy uses high-tech products such as laparoscopes and fiber choledochoscopes. First, a pneumoperitoneum needle is inserted into the laparoscope through abdominal puncture to explore the position of the gallbladder, its appearance, and whether there are adhesions. After confirming that the outside of the gallbladder is normal, a small incision of 2 cm is made along the rib margin to enter the abdomen and pull the gallbladder. An incision of about 0.5 cm is made at the bottom of the gallbladder to insert the choledochoscopic instrument, and the bile in the gallbladder is sucked out with a negative pressure suction device. At the same time, normal saline is placed in the gallbladder cavity to flush the gallbladder cavity to make the field of vision clear, and the stones in the gallbladder are removed under direct vision of the fiber choledochoscope. Finally, a choledochoscope is used to repeatedly check whether there are any small stones remaining in the gallbladder cavity, and the flow of bile into the gallbladder is observed to rule out the presence of stones stuck in the cystic duct. After confirming that there are no stones in the gallbladder, the gallbladder is carefully sutured in two layers with absorbable sutures, and finally the surgical incision is sutured layer by layer.

Extracorporeal shock wave lithotripsy

In 1984, Lauerbwch first used extracorporeal shock wave-lithotripsy (ESWL) to treat cholelithiasis. The commonly used shock wave lithotripter is the EDAP LT-01 model, which consists of 320 piezoelectric crystals embedded in a parabolic disk. It emits shock waves synchronously to form a gathering area of ​​4 mm wide and 75 mm long, with a sound pressure of 9×107PZ. Generally, an impact frequency of 1.25 to 2.5 times/sec and a treatment power of 100% are used, which lasts for 60 to 75 minutes, and the stones in the gallbladder can be crushed. In addition, B-mode ultrasound real-time imaging is used to locate stones and monitor the lithotripsy process.

Disadvantages: Extracorporeal lithotripsy only breaks up stones but does not expel them. During the process of self-excretion of the broken stones, "stone streets" may be formed, which may affect kidney function or even completely lose kidney function.

Ultrasonic lithotripsy

Under ultrasound guidance, percutaneous gallbladder puncture is performed first, and then the puncture needle channel is enlarged and a cholecystoscope is inserted into the gallbladder. Under direct vision of the cholecystoscope, ultrasound is used to crush the stones, and the crushed stones are sucked out. After the operation, a balloon drainage tube was placed in the gallbladder. Because this method has been used clinically for a short time, its exact effect needs further observation.