Laparoscopic transcystic laser lithotripsy for common bile duct stone clearance.

Objective: Laparoscopic transcystic common bile duct (CBD) exploration is a safe single-stage procedure for CBD stone clearance. The aim of this report was to describe our experience of transcystic laser lithotripsy in patients with complex CBD stones.

Methods: Data from consecutive patients treated with transcystic holmium:YAG laser lithotripsy was collected and analyzed concerning age, sex, number of stones, duct clearance, conversions, operation time, complications, and hospital stay.

Results: Duct clearance was achieved in all (n=8) patients as a single-stage procedure, although 1 had to be converted to open surgery. Median operation time was 225 minutes and hospital stay was 2 days. There was no postoperative morbidity or mortality.

Conclusions: Laparoscopic transcystic use of holmium:YAG laser for complex CBD stones seems safe and efficient even though operation time is long. The technique has the potential of completing the treatment armamentarium for transcystic laparoscopic clearance of difficult CBD stones.