Percutaneous cholecystolithotomy with endoscopic lithotripsy by using a pulsed-dye laser: preliminary experience

Percutaneous cholecystolithotomy with endoscopically directed lithotripsy with a pulsed-dye laser was performed in eight patients for the treatment of symptomatic gallstones. All patients had stones that were not amenable to therapy by less invasive techniques. During the first stage of a two-stage procedure, a cholecystostomy catheter was placed percutaneously. During the second stage, performed at least 10 days later, the stones were fragmented with a laser and removed. Fragmentation of the stones was successful in all patients. In six patients, the gallbladder was completely cleared of stones, as assessed with endoscopy and cholecystography. In two patients, residual fragments remained in the gallbladder. No laser-related complications occurred. This preliminary experience suggests that the pulsed-dye laser is safe and effective in endoscopically directed lithotripsy of gallbladder stones.