Pulse Dye Laser Lithotripsy for Large Biliary Tract Stones

SUKIJ PANPIMANMAS, M.D.*, SUCHART CHANTAWIBUL,M.D.*, THAWEE RATANACHU-EK, M.D.*

Affiliation : *Department of Surgery, Rajavithi Hospital, Bangkok 10400, Thailand.

AbstractFrom 1997 to 1998 the first series of 21 patients with large biliary tract stones ( 1.5-4.0 em with average 2.5 em in diameter) who underwent endoscopic stone extraction by using com- bination of ERCP and EST with automatic stone-tissue detection pulse dye laser was carried out. Male= 8, Female= 13, average age= 57.5 years (32-83) most of the stones were primary stones (71.4o/c ). Laser fibers were controlled by balloon catheter with fluoroscope (blind technique) in 16 cases and by mother-babyscope system in 5 cases. The result in successful fragmentation of stones was 87.5 per cent with the blind technique and 100 per cent with the mother-babyscope technique. Temporary stents were used in the patients who had severe cholangitis and those who required more than one session of lithotripsy (I 9% ). Complications consisted of controllable cholangitis in 2 cases (9.5%) and there was no mortality. We conclude that stone-tissue detection lithotripsy is very safe and effective in patients with large biliary tract stones and high surgical risk especially via the direct mother-babyscope system.

Keywords : Laser Lithotripsy, Biliary Tract Stones

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