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A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy
Published on: September 13, 2022
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Tips for percutaneous nephrolithotomy for transplant kidney stone.
Takafumi Yagisawa1,2, Tomokazu Shimizu2,3, Ayane Tachiki1,2
1Department of Urology and Kidney Transplantation Toda Chuo General Hospital Saitama Japan.
IJU Case Reports
|January 3, 2025
Summary
Percutaneous nephrolithotomy effectively fragmented a large kidney allograft stone in a transplant recipient. This minimally invasive approach offers a safe solution for managing complex urinary tract stones in kidney transplant patients.
Area of Science:
- Nephrology
- Urology
- Transplant Surgery
Background:
- Kidney allograft stones pose unique management challenges in transplant recipients.
- De novo stones in transplanted kidneys require specific clinical considerations.
Purpose of the Study:
- To describe a case of successful percutaneous nephrolithotomy for a large kidney allograft stone.
- To highlight the efficacy of percutaneous nephrolithotomy in managing complex kidney allograft stones.
Main Methods:
- A 57-year-old simultaneous pancreas-kidney transplant recipient with a 23-mm kidney allograft stone underwent percutaneous nephrolithotomy.
- Stone fragmentation was achieved using pneumatic and ultrasonic lithotripsy.
- A subsequent procedure ensured complete stone clearance and ureteral stent placement.
Main Results:
- Percutaneous nephrolithotomy successfully fragmented a large kidney allograft stone (≥20 mm).
- The procedure was adapted from initial endoscopic attempts due to anatomical challenges.
- Complete stone clearance was achieved with a secondary procedure.
Conclusions:
- Percutaneous nephrolithotomy is a safe and effective treatment for large kidney allograft stones.
- Understanding percutaneous approach nuances is crucial for successful allograft stone management.
- Pneumatic and ultrasonic lithotripsy are viable tools for kidney allograft stone fragmentation.
