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Related Experiment Videos

Experimental cholelitholysis with the pulsed tunable dye laser.

B W Chang1, M E Pollock, J Eugene

  • 1Department of Surgery, University of California, Irvine 92668.

Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research
|January 1, 1991
PubMed
Summary

Pulsed tunable dye lasers can fragment gallstones, but the high power required for fragmentation also risks common bile duct perforation. This laser technology shows potential but necessitates careful power management to avoid injury during cholelitholysis.

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Area of Science:

  • Medical Devices
  • Laser Technology
  • Gastroenterology

Background:

  • Gallstones (cholelithiasis) are a common medical condition requiring treatment.
  • Cholelitholysis, the dissolution of gallstones, is an area of ongoing research for less invasive treatments.
  • Pulsed tunable dye lasers offer a potential modality for gallstone fragmentation.

Purpose of the Study:

  • To evaluate the efficacy and safety of a pulsed tunable dye laser for cholelitholysis.
  • To determine the power and energy thresholds for gallstone fragmentation.
  • To assess the risk of common bile duct injury associated with laser fragmentation.

Main Methods:

  • A pulsed tunable dye laser (504 nm, 10 Hz, 1.2 µs pulse width) was used to ablate 55 gallstones from 14 patients.

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  • Laser power ranged from 10-40 kW, delivered via a 250-micron quartz fiber optic in direct contact with stones under saline.
  • Fragmentation efficacy and energy requirements were assessed, and potential injury to common bile ducts (autopsy specimens) was evaluated.

    • Main Results:

    • The laser successfully fragmented 55 gallstones of various compositions (35 cholesterol, 20 bilirubin), including calcified types.
    • Fragmentation required power levels of 20 kW for 2 stones and 40 kW for 53 stones.
    • Common bile duct perforation occurred rapidly (1.1 ± 0.1 s) at the 40 kW power level (0.44 ± 0.04 J).

    Conclusions:

    • Pulsed tunable dye lasers are capable of fragmenting gallstones across all compositions.
    • The threshold power for effective gallstone fragmentation is 40 kW.
    • Laser energy sufficient for gallstone fragmentation poses a significant risk of common bile duct injury, highlighting safety concerns.