Analysis of Efficacy and Safety of Laparoscopy plus Choledochoscopy Combined with Holmium Laser Lithotripsy for Choledocholithiasis and Hepatolithiasis

Background:This study aimed to evaluate the efficacy and safety of laparoscopy combined with choledochoscopy-assisted holmium laser lithotripsy in managing biliary tract stones. Methods:From March 2023 to March 2024, a prospective study was carried out on 71 patients suffering from choledocholithiasis and/or hepatolithiasis. Each patient received a laparoscopic common bile duct exploration with choledochoscopic visualization and holmium laser lithotripsy of stones. Information was gathered on patient age and sex, stone type and size, intraoperative and postoperative outcomes. Results:Successful stone clearance was accomplished in 95.8% of cases, accompanied by negligible intraoperative complications (1.4%); low bile leakage rates (2.8%); and infrequent postoperative fever (7.0%). Conversion to open surgery was only required in 4.2% of patients. The average length of stay was 4.2 days. At 3-month follow-up, stone recurrence was noted in 2.8% of patients. Conclusion:Laparoscopy combined with choledochoscopy and holmium laser lithotripsy is a highly effective and safe approach for managing biliary tract stones. It ensures optimal stone clearance with minimal complications and should be considered a valuable alternative to conventional methods in suitable candidates.