Gallstone Lithotripsy: In Vitro Comparison of Fragmentation with a Tunable-Dye Laser and an Ultrasonic Wire

A review of technical and clinical aspects of biliary laser lithotripsy

OBJECTIVE

This paper reviews the current use of laser techniques for the treatment of biliary stones.

BACKGROUND DATA

Biliary stones may pose a special problem when access to them is limited, when previous attempts of removal have failed, or when a less invasive option than surgery is needed. The availability of various laser sources and the adaptation of the technology for safe use in the biliary system make the use of laser energy for stone fragmentation possible.

METHODS

Current literature is reviewed concerning the use of laser for biliary lithotripsy, including experimental data and experience with human series. Technology, indications, alternatives, and cumulative world experience are discussed.

CONCLUSIONS

Recent technical advances have made the use of laser energy for fragmentation of biliary calculi possible. It is a valid option for treatment of "difficult" stones, when other methods have failed or as a primary treatment in certain situations. The technical complexity and the high cost limit its use for specialized centers.