Holmium: YAG laser lithotripsy for gallstones. A preliminary report

Surgical Endoscopy
J M TeichmanR M Cossman

Abstract

Most retained gallstones can be extracted at the time of operative exploration or endoscopic retrograde cholangiopancreatography (ERCP). Infrequently, impaction or associated anatomic abnormalities may prevent their clearance. We assessed the efficacy of the holmium:YAG laser in managing retained biliary calculi that had proven refractory to the usual methods of extraction. Two patients with calculi impacted in the intrapancreatic common bile duct and one patient with residual stones in a nonfunctional gallbladder were treated with holmium:YAG laser lithotripsy. Two of these patients were treated under conscious sedation, and one received a general endotracheal anesthetic. Laser energy was delivered by a 272-mm optical fiber inserted through a 7-Fr fiberoptic endoscope. The ablative effects were monitored continuously via videoscopic. All of the stones were cleared successfully in a single therapeutic setting. In one patient, fragments of the impacted intraductal stone were extracted with an endoscopic wire basket. In the other two patients, stone debris was completely cleared with saline irrigation. No complications developed, and all patients remained free of recurrence during a 6-month follow-up period. The holmium:YAG laser...Continue Reading

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Citations

Apr 25, 2009·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Oscar SchatloffHarry Winkler
Jun 19, 2010·Gut and Liver·Chan Sup Shim
Jun 11, 2015·Einstein·Fernando KorkesAntônio Luiz de Vasconcellos Macedo
Jan 31, 2015·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Ulf PeterssonAgneta Montgomery
Jun 28, 2002·BMC Gastroenterology·Mohammad M AlsolaimanBenedict J Maliakkal
Jun 20, 2002·Current Opinion in Urology·Joel M H Teichman
Apr 26, 2019··Pavel BohácekJan Šulc

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