Endoscopic retrograde cholangiopancreatography (ERCP) with laser lithotripsy is a minimally invasive procedure used to remove gallstones from the bile ducts. It combines endoscopy with laser technology to fragment and extract stones, offering an effective treatment for patients with choledocholithiasis.

Procedure Overview: During an ERCP with laser lithotripsy, an endoscope is passed through the mouth into the duodenum, allowing access to the bile ducts. A laser fiber is then inserted through the endoscope and directed towards the gallstones. The laser energy is used to break the stones into smaller fragments, which can then be removed using specialized instruments.

Indications: This procedure is indicated for patients with gallstones that have migrated from the gallbladder into the bile ducts, causing obstruction, infection, or other complications. ERCP with laser lithotripsy is particularly beneficial for cases where traditional methods, such as endoscopic sphincterotomy or balloon dilation, are not feasible or effective.

Benefits: ERCP with laser lithotripsy offers several advantages, including high success rates in stone clearance, reduced risk of complications compared to surgical interventions, shorter recovery times, and preservation of the gallbladder in select cases. It allows for precise targeting of stones and minimizes damage to surrounding tissues.

Risks: While ERCP with laser lithotripsy is generally safe, there are potential risks associated with the procedure, such as pancreatitis, bleeding, perforation of the bile ducts, or adverse reactions to sedation. However, these risks are relatively low and are outweighed by the benefits for most patients.