The holmium-YAG laser: a suitable instrument for stone fragmentation in choledocholithiasis. The assessment of the results of its use under babyscopic control

Abstract

Stone fragmentation is required in ca. 5% of patients with choledocholithiasis to free the patients of stones. Several extra- and intracorporal methods of stone fragmentation (lithotripsy) have been available. We here report our experience with the recently available holmium-YAG laser, used under babyscopic monitoring. Between September 1997 and May 1998 lithotripsy was performed by holmium-YAG laser under monitoring in 20 patients with choledocholithiasis in whom conventional methods had failed to achieve stone fragmentation. All stones were cleared in 19 of the 20 patients. A second session was necessary in four patients, three sessions in one. There was no serious complication and no death during a 30-day follow-up. Holmium-YAG laser lithotripsy under babyscopic monitoring has been shown to be a suitable method in patients with choledocholithiasis in whom previous treatment has failed it is complementary to current methods of stone fragmentation.