Endoscopy 2019; 51(04): S15-S16
DOI: 10.1055/s-0039-1681213
ESGE Days 2019 oral presentations
Friday, April 5, 2019 08:30 – 10:30: ERCP stones Club H
Georg Thieme Verlag KG Stuttgart · New York

ELECTROHYDRAULIC LITHOTRIPSY (EHL) WITH A SHORT-ACCESS-MOTHER-BABY-SYSTEM (SAMBA) FOR THE THERAPY OF COMPLICATED BILE DUCT STONES (SAMBA-EHL STUDY)

S Boedeker
1   Medizinische Klinik II, Technische Universität München, München, Germany
,
S von Delius
2   Medizinische Klinik II, RoMed Klinikum Rosenheim, Rosenheim, Germany
,
B Neu
3   Medizinische Klinik, Klinikum Landshut/Achdorf, Landshut, Germany
,
A Weber
4   Medizinische Klinik, Wertachkliniken, Bobingen, Germany
,
RM Schmid
1   Medizinische Klinik II, Technische Universität München, München, Germany
,
E Frimberger
1   Medizinische Klinik II, Technische Universität München, München, Germany
,
M Abdelhafez
1   Medizinische Klinik II, Technische Universität München, München, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Cholangioscopy with EHL is a method of choice for managing complicated bile duct stones. The SAMBA-system is a new endoscope with a shortened baby scope, which allows a more direct handling. Up to now only a few studies evaluated the SAMBA-scope. The aim of the actual study was to evaluate the effectiveness of EHL during cholangioscopy utilizing the SAMBA-scope.

Methods:

The SAMBA-EHL study was a prospective, single-center and investigator initiated trial. The primary endpoint of the study was the rate of complete stone clearance after therapy. Patients > 18 years with choledocholithiasis after failed conventional extraction attempts were included. Exclusion criteria were general contraindications to ERC, ASA classes IV-VI, and the presence of a pacemaker or ICD. After admission to the study, peroral cholangioscopy was performed with the SAMBA-system (Karl-Storz, Tuttlingen) and EHL (Walz Elektronik, Rohrdorf). Successful stone-removal was confirmed by cholangiography and cholangioscopy. Clinical follow up was performed after 30 days.

Results:

31 patients (16 men, 15 women) at a median age of 73 (32 – 94) years participated in the study during September 2014 thru December 2016. In 39 examinations a median stone size of 15 mm (7 – 25) was identified during a median procedure time of 95 min (30 – 180). For sedation, a median propofol dose of 905 mg (340 – 1800) was applied. Patients' stone clearance required on average 1.3 sessions. 24 patients required 1 EHL session, 6 required 2 and 1 patient required 3 sessions. One examination was stopped due to failure of the EHL probe. 5 patients needed further ERCPs to eventually retrieve residual stone fragments. Finally, all 31 patients were successfully treated. Minor complications included cholangitis (n = 4), pancreatits (n = 1) and sepsis (n = 1).

Conclusions:

Therapy with EHL applied with the SAMBA-scope is an efficient and safe treatment for complicated choledocholithiasis.