Treatment of incarcerated choledocholithiasis with holmium laser in laparoscopic bile duct exploration.

Laparoscopic biliary tract exploration is a minimally invasive surgery for biliary calculi. Most of the stones could be removed by conventional surgical methods including lithotomy forceps and choledochoscopy, but for the incarceration stones of the bile duct, it is technically challenging to crush the stones directly by the lithotomy forceps. We retrospective clinical data describing the long-term experience of incarcerated choledocholithiasis with holmium laser in laparoscopic bile duct exploration (LCBDE). We enrolled 35 patients who were treated with holmium laser in LCBDE. All patients successfully completed the operation, no conversion to laparotomy. The mean of operation time was 106.0 ± 18.5 min, and holmium laser lithotripsy time was 15.1 ± 5.5 min. The incarcerated calculus removed rat was 100%. No procedure related complication or mortality was reported. For incarcerated choledocholithiasis, combination of holmium laser and fiber choledochoscopy in LCBDE dramatically improves the success rate of stone removal.