Laparoscopic common bile duct exploration and holmium laser lithotripsy: a novel approach to the management of common bile duct stones

Varban, Oliver A.; Assimos, Dean G.; Passman, Corey; Westcott, Carl

doi:10.1007/s00464-009-0837-0

Cited by 33 publications

(27 citation statements)

References 18 publications

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“…Consequently, the majority of surgeons use the transductal approach directly through the CBD. Regardless of exact technique used, the high rates of duct clearance reported with LBDE119 120 125–129 can be increased to near 100% with the availability of intraductal piezoelectric or LL 130. Long-term results also appear favourable 131 132.…”

Section: Surgical Management Of Cbdsmentioning

confidence: 99%

Updated guideline on the management of common bile duct stones (CBDS)

Williams

Beckingham

Sayed

et al. 2017

Gut

367

293

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Section: Surgical Management Of Cbdsmentioning

confidence: 99%

Updated guideline on the management of common bile duct stones (CBDS)

Williams

Beckingham

Sayed

et al. 2017

Gut

367

293

View full text Add to dashboard Cite

“…Of these, basket retrieval systems may increase the risk of bile duct mucosa injury . EHL is an inexpensive technique used mainly for difficult biliary stones; however, there are many complications, such as recurrent jaundice, cholangitis, perforation and bleeding .…”

Section: Discussionmentioning

confidence: 99%

“…Several previous studies demonstrated that holmium laser lithotripsy was a safe and effective method to manage impacted biliary stones; however, it required continuous visual control of the fragmentation procedure because of the high energies with long pulse durations that are used; the probe contacting the bile duct wall may result in perforation, bleeding, biliary leakage and other serious complications . Moreover, because of the inability of the surgeon to visualize the area, holmium laser lithotripsy should be ceased in severe intraoperative haemobilia, which is extremely hard to manage .…”

Section: Discussionmentioning

confidence: 99%

Clinical role of frequency‐doubled double‐pulse neodymium YAG laser lithotripsy for removal of difficult biliary stones in laparoscopic common bile duct exploration

Yang

et al. 2019

ANZ Journal of Surgery

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Background: The optimal methods for patients with difficult biliary stones remain under debate. The aim of this study was to evaluate the role of frequency-doubled double-pulse neodymium YAG (FREDDY) laser lithotripsy for removing difficult biliary stones during laparoscopic common bile duct exploration (LCBDE). Methods: Between March 2013 and January 2015, 42 consecutive patients with difficult biliary stones who underwent LCBDE with FREDDY laser lithotripsy were included in this study. The clinical data of all patients were retrospectively collected and analysed. Results: Bile ducts were completely cleared in all patients. The complications related to laser lithotripsy were not noted. A total of 38 patients (90.5%) underwent primary closure of common bile duct, and T-tube drainage was applied to four patients (9.5%). No bile duct injury, bleeding and perforation were observed. There were no post-operative surgery-related deaths. Bile leakage occurred in four patients (9.5%) with primary closure procedure, and all of them were managed successfully with conservative therapy. The median follow-up period was 42.8 months, with no evidence of bile duct stricture and stone recurrence in all patients. Conclusions: The LCBDE combined with FREDDY laser lithotripsy appear to be effective and safe for the treatment of difficult biliary stones.

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“…12–14 Reports have described the combined use of a choledochoscope with lithotripsy in treating calculi of the bile duct. 15,16 The dual-band, dual-pulse laser lithotripsy developed in the 1990s has replaced the holmium laser as the optimal laser lithotripsy method. Moreover, this method is more suitable for use in treating biliary calculi.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Transcystic Treatment Biliary Calculi by Laser Lithotripsy

Jin

Zhang

2016

JSLS

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Background and Objectives: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.Conclusion: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.

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Laparoscopic common bile duct exploration and holmium laser lithotripsy: a novel approach to the management of common bile duct stones

Cited by 33 publications

References 18 publications

Updated guideline on the management of common bile duct stones (CBDS)

Updated guideline on the management of common bile duct stones (CBDS)

Clinical role of frequency‐doubled double‐pulse neodymium YAG laser lithotripsy for removal of difficult biliary stones in laparoscopic common bile duct exploration

Laparoscopic Transcystic Treatment Biliary Calculi by Laser Lithotripsy

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