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Article |

Laser Lithotripsy for the Management of Retained Stones

Leon G. Josephs, MD; Desmond H. Birkett, MD
Arch Surg. 1992;127(5):603-605. doi:10.1001/archsurg.1992.01420050131017.
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• The morbidity of reoperation for retained biliary stones is not insignificant. 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-μm 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.

(Arch Surg. 1992;127:603-605)


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