Choledochoscopic lithotripsy is a useful adjunct to laparoscopic common bile duct exploration for hepatolithiasis: a cohort study

BackgroundThis study aims to investigate the role of combining choledochoscopic lithotripsy with laparoscopic common bile duct exploration for hepatolithiasis in patients who are not suitable for hepatectomy.MethodsFrom March 2009 to March 2013, 86 patients with hepatolithiasis irrespective of whether they underwent a choledochoscopic plasma shock wave lithotripsy or not were analyzed.ResultsSixty-two patients underwent lithotripsy and 24 patients underwent basket lithoextraction intraoperatively. Plasma shock wave lithotripsy did not lengthen the operating time, but decreased the postoperative residual stone rate and reduced the frequency of postoperative choledochoscopic lithotomy for patients with remnant stones. The overall final stone clearance rate was 98.8%. During a mean follow-up of 26.2 months, recurrent stones and cholangiocarcinoma developed in 1 patient, respectively.ConclusionLaparoscopic common bile duct exploration combined with choledochoscopic lithotripsy is a definitive procedure for hepatolithiasis in patients who are not candidates for hepatectomy.