METHOD OF TREATING CHOLEDOCHOLITHIASIS Russian patent published in 2024 - IPC A61B18/26 A61B17/94 A61B1/05 A61B1/273 A61M25/10 

FIELD: medicine; endoscopy; hepatobiliary surgery.

SUBSTANCE: lithotripsy is performed with FiberLase U2 apparatus. Using a laser fiber with diameter of 160–600 mcm, a concrement shell is affected in the "Popcorn" mode with pulse energy parameters of 0.10–0.15 J, frequency 100–270 Hz, power 10–40 W for 1–30 minutes to destruction of the shell into fragments from 1 to 10 mm in diameter. After that, the concrement nucleus is exposed in the "Fragmentation" mode with pulse energy parameters 3.00–5.00 J, frequency 8.3–120 Hz, power 30 W for 1–20 minutes to destruction of concrement nucleus into fragments from 1 to 8 mm in diameter. At the same time access to common bile duct is created by means of preliminary endoscopic papillosphincterotomy with its addition with balloon dilatation with a combination of constant saline supply into the bile duct lumen and its aspiration through the choledochoscope and duodenoscope instrumental channels.

EFFECT: method makes it possible to increase efficiency of treatment due to complete destruction of large concrements, wherein the treatment is low-traumatic for the duct systems of the liver even with a short-term exposure to the active beam; destruction of surface layers of stones occurs already at the first effects of laser fiber on it due to optimally selected settings of power and frequency modes, in addition, the exposure time is significantly reduced in comparison with analogues of the method.

1 cl, 2 ex, 2 dwg