ENDOSCOPIC INTRACORPOREAL LITHOTRIPSY FOR SIALOLITHIASIS

Purpose: This article describes a technique of salivary gland endoscop y using a 2.1-mm endoscope with a l-mm working channel. The technique allows intracorporeal lithotripsy under endoscopic control. Two types of energy to produce calculi fragmentation were analyzed. Patients and Methods: Of 39 patients who presented with obstructive sialoadenitis, endoscopic treatment was possible in 27. Eighteen had a diagnosis of sialolithiasis. Intracorporeal lithotripsy was done under endoscopic c ontrol in these patients. Laser energy was used to produce fragmentati on in 3 cases and pneumobalistic energy in 9. In 6 cases, the calculi were extracted with forceps.Results: Fifteen patients are free of ston es and symptoms after a 6-month follow-up. Fragmentation and extractio n of the calculi were not possible in 3 patients. Two of these patient s required open surgery. The other patient is under observation. Concl usions: The use of endoscopes with a working channel allows irrigation to improve visibility during exploration. Both extraction of calculi and lithiasis fragmentation using different energies can be carried ou t through the channel. In this series, pneumoballistic energy (Lithocl ast) has been shown to produce calculus fragmentation with more effici ency than lasertripsy (Dornier Impact). When dilation and placement of a canula (Abocath 16 G) was done 2 days preoperatively, endoscopy was performed more easily. Postoperative drainage has proven effective in avoiding complications.