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Surgical Innovation
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The Use of Holmium Laser Technology for the Treatment of Refractory Common Bile Duct Stones, With a Short Review of the Relevant Literature

Andrew Day, MBBS, BSc, MRCS

Department of Surgery, Worthing and Southlands Hospitals NHS Trust, West Sussex, United Kingdom, daylad24{at}hotmail.com

Mazin E. Sayegh, MBChB, MSc, FRCS

Department of Surgery, Worthing and Southlands Hospitals NHS Trust, West Sussex, United Kingdom

Christof Kastner, BM, PhD, FRCS(Urol), FEBU

Department of Urology Worthing and Southlands Hospitals NHS Trust, West Sussex, United Kingdom

Tom Liston, MCh, FRCS(Urol)

Department of Urology Worthing and Southlands Hospitals NHS Trust, West Sussex, United Kingdom

Background. The treatment of common bile duct (CBD) stones can vary in complexity and many methods exist to fragment them before removal. Although holmium laser is frequently used in urological surgery, it is rarely used to achieve this aim. Methods. The holmium laser was passed along a fiber introduced via a flexible scope through the cystic duct at the time of laparoscopic cholecystectomy. This energy modality was used to fragment the stones to a size that allowed easy removal. Results. The authors have used this technique once so far and achieved complete clearance of the CBD with no mucosal damage. Conclusion. Holmium laser provides an alternative and realistic treatment option for difficult CBD stones.

Key Words: gall stones • laser • bile duct

Surgical Innovation, Vol. 16, No. 2, 169-172 (2009)
DOI: 10.1177/1553350609338373


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