Fragmentation of difficult bile duct stones: Impact of Argon-Plasma-Coagulation (APC), Cryo- and WaterJet-technology

Aims: In case of bile duct stones, complete clearance of the bile duct by conventional endoscopic stone extraction methods is achievable in over 90% of cases. In patients with difficult and/or giant stones, additive endoscopic fragmentation techniques like laser or electrohydaulic lithotripsy are required. APC is a well-known thermal technology with devitalization and fragmentation effects in high temperatures. Cryo-technology utilizes the selective, controlled application of freeze-thaw cycles with low temperature (-89° to -196°C) in order to devitalize pathological tissue. The dissecting WaterJet (Erbe Waterje…