Percutaneous endoscopic laser lithotripsy of a cystic duct stone:  a case report.
A case report of an elderly patient with severe heart disease and chronic obstructive pulmonary disease who required laser lithotripsy for a retained cystic duct stone is presented.  This high-risk patient underwent a laparoscopic cholecystostomy and gallstone removal as treatment for symptomatic gallstone disease.  On cholecystography the patient was found to have a small stone fragment in the cystic duct.  Under intravenous sedation this stone fragment was fragmented and removed using an 8.5F flexible ureteroscope and a coumarin pulsed-dye laser lithotriptor.  The stone was fragmented and washed into the common bile duct. Follow-up cholecystogram prior to removal of the cholecystostomy tube demonstrated no stones in the gallbladder, cystic duct, or common bile duct.  The management of percutaneous removal of retained stones is reviewed.
Departments of Surgery and Radiology, Boston University Medical Center, MA 02118.
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Birkett
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Greenfield
D000368:Aged; D002767:Cholecystostomy / Q000379:methods*; D002769:Cholelithiasis / Q000601:surgery / Q000628:therapy*; D003549:Cystic Duct; D016145:Endoscopy, Digestive System / Q000379:methods; D006801:Humans; D053685:Laser Therapy; D008096:Lithotripsy / Q000379:methods*; D017602:Lithotripsy, Laser; D008297:Male