FLUOROSCOPICALLY GUIDED LASER LITHOTRIPSY OF A PANCREATIC DUCT STONE

A 54-year-old man with early stage chronic pancreatitis and an impacte d ductal stone in the pancreatic head complicated by a 2 cm abscess wa s treated with pulsed dye laser lithotripsy using an automatic stone t issue differentiation system under fluoroscopic control. This system a utomatically switches off the laser on contact with tissue. The 0.25 m m quartz fiber introduced into the pancreatic duct via a 5 French tefl on catheter delivered 165 out of 1000 pulses at contact with the stone (100 mJ, 10 Hz). Partial stone disintegration was achieved making mec hanical stone removal possible which initially failed. No major side-e ffect occurred. This new laser with a stone detection system seems to render fluoroscopically guided laser lithotripsy in the pancreatic duc t safer thus warranting further clinical trials.