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Laser fragmentation of pancreatic duct stones using a rhodamine laser with an automatic stone-tissue detection
1Department of Medicine C, Klinikum Ludwigshafen, Academic Teaching Hospital of the University of Mainz, Germany.
Objectives:
The aim of our study was to examine the suitability of a rhodamine 6G laser with an integrated stone-tissue detection system (STDS) for fragmenting pancreatic stones.
Methods:
A total of 64 pancreatic duct stones were measured for weight, diameter, main chemical components and in some cases for their computerized tomography density. Recognition of all stones was checked with the standard STDS or a prototype version. Number of fragmentation pulses, total fragmentation energies and correlation with the individual stone parameters were determined. The quality of the tissue-detection mode was evaluated in postmortem pancreata.
Results:
The standard STDS detected only 45% of the pancreatic stones correctly. When using the prototype, the detection rate improved significantly up to 75% (P < 0.01). All laser pulses were cut off if tissue contact occurred. All the stones were completely disintegrated by the laser pulses. A slight correlation was found only between the required fragmentation energy and the stone weight (linear regression: R2 = 0.77); other factors had no significant impact.
Conclusion:
The rhodamine 6G laser is suitable for the fragmentation of pancreatic stones in vitro. The integrated STDS is less effective for pancreatic stones than reported for biliary stones.