Introduction:

In approximately 10% to 15% of patients it is not possible to remove stones from the bile duct by ERCP, these stones are considered difficult to manage. Failure to eliminate bile duct stones results in biliary obstruction, cholangitis and pancreatitis with the consequent increase in morbidity and mortality. Spy glass with laser has been introduced as a new option for the treatment of difficult-to-manage choledocholithiasis. We present a review of 10 cases of difficult choledocholithiasis solved by cholangioscopy with spyglass and laser lithotripsy.

Objective:

To assess the usefulness of cholangioscopy by spyglass and laser lithotripsy in the resolution of difficult choledocholithiasis.

Material and methods:

This is a retrospective, observational and descriptive study from January 2015 to January 2019 of patients who underwent cholangioscopy by means of spyglass and laser lithotripsy for diagnosis of difficult choledocholithiasis.

Results:

In the 48-month period, 10 patients were operated, 3 male and 7 female. The average age was 62 years. The average surgical time of 70min. No incidents or transoperative or postoperative complications arose. The average hospitalization time after cholangioscopy was 72 hrs. Cholangiography was performed after cholangioscopy without evidence of residual stones or filling defects of the bile duct. There have been no recurrences. There were no cases of mortality.

Conclusions:

Laser lithotripsy by means of cholangioscopy by Spyglass is a good therapeutic option for the resolution of difficult-to-manage choledocholithiasis.

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