title: Laparoscopic Transcystic Treatment Biliary Calculi by Laser Lithotripsy.
abstract: OBJECTIVE
  Laparoscopic transcystic common bile duct exploration (LTCBDE) is a complex procedure requiring expertise in laparoscopic and choledochoscopic skills. The purpose of this study was to investigate the safety and feasibility of treating biliary calculi through laparoscopic transcystic exploration of the CBD via an ultrathin choledochoscope combined with dual-frequency laser lithotripsy.
  
  
  METHODS
  From August 2011 through September 2014, 89 patients at our hospital were treated for cholecystolithiasis with biliary calculi. Patients underwent laparoscopic cholecystectomy and exploration of the CBD via the cystic duct and the choledochoscope instrument channel. A dual-band, dual-pulse laser lithotripsy system was used to destroy the calculi. Two intermittent laser emissions (intensity, 0.12 J; pulse width 1.2 μs; and pulse frequency, 10 Hz) were applied during each contact with the calculi. The stones were washed out by water injection or removed by a stone-retrieval basket.
  
  
  RESULTS
  Biliary calculi were removed in 1 treatment in all 89 patients. No biliary tract injury or bile leakage was observed. Follow-up examination with type-B ultrasonography or magnetic resonance cholangiopancreatography 3 months after surgery revealed no instances of retained-calculi-related biliary tract stenosis.
  
  
  CONCLUSIONS
  The combined use of laparoscopic transcystic CBD exploration by ultrathin choledochoscopy and dual-frequency laser lithotripsy offers an accurate, convenient, safe, effective method of treating biliary calculi.
authors.affiliation: Department of General Surgery, Beijing Friendship Hospital, Capital Medicine University Beijing, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of General Surgery, Beijing Friendship Hospital, Capital Medicine University Beijing, China.
authors.forename: Lan
authors.initials: L
authors.lastname: Jin
authors.affiliation: Department of General Surgery, Beijing Friendship Hospital, Capital Medicine University Beijing, China.
authors.forename: Zhongtao
authors.initials: Z
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D003135:Common Bile Duct / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D017602:Lithotripsy, Laser / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Biliary calculi; Dual-frequency laser; Laparoscope; Transcystic common bile duct exploration; Ultrathin choledochoscope