Laser lithotripsy for the management of retained stones.
The morbidity of reoperation for retained biliary stones is not significant. Many techniques have been developed to avoid reoperation. This study analyzes T-tube tract choledochoscopy and lithotripsy using a 504-nm pulsed dye laser for treatment of retained stones. A flexible choledochoscope is passed into the biliary tract and laser energy is delivered under endoscopic visualization after passing a 320-microns laser fiber through the instrument channel. Eight patients were treated in nine sessions. The mean number of pulses was 1512.33, delivered at 3 to 5 Hz with an energy of 100 to 120 mJ. In all patients, the biliary tract was cleared. A single patient's treatment was complicated by transient bacteremia. Mean follow-up was 10 months. Choledochoscopic laser lithotripsy is a safe, effective technique that may also play a major role in laparoscopic common duct surgery.
Josephs
L G
LG
Section of Gastrointestinal Surgery, Boston University School of Medicine, MA.
Birkett
D H
DH
D001900:Boston / Q000453:epidemiology; D002763:Cholecystectomy; D005500:Follow-Up Studies; D042882:Gallstones / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006785:Hospitals, University; D006801:Humans; D053685:Laser Therapy / Q000379:methods / Q000592:standards*; D008096:Lithotripsy / Q000379:methods / Q000592:standards*; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D011859:Radiography; D012086:Reoperation