Safety and Effectiveness of Percutaneous Electrohydraulic and Laser Lithotripsy in the Management of Biliary Stones: The Multicenter National Percutaneous Cholangioscopy Registry

Purpose: To analyze potential differences between the outcomes (including clinical success, biliary tube removal, and adverse event [AE] rates) of percutaneous electrohydraulic lithotripsy (PEHL) and percutaneous laser lithotripsy (PLL) for the treatment of biliary stones using multicenter retrospective data. Materials and Methods: Multicenter retrospective data regarding patients undergoing PEHL and PLL procedures were extracted from the National Percutaneous Cholangioscopy Registry. Data points included patient and procedure demographic information, procedural/clinical success, AEs, and biliary tube removal rate. Stones in the intra- and extrahepatic biliary ducts, cystic duct, and gall bladder were included. Data from 6 clinical sites regarding 93 PEHL procedures in 75 patients and 184 PLL procedures in 89 patients were reviewed. Clinical success was defined as improvement in clinical symptoms (eg, abdominal pain, fever, jaundice, and nausea and vomiting), imaging findings, and/or laboratory values. Results: Clinical success was achieved in 92.4% of PEHL procedures and 98.4% of PLL procedures, a difference without statistical significance (P = .656). Moderate or severe AEs occurred in 4.3% of PEHL procedures and 3.3% of PLL procedures, a difference without statistical significance (P = .713). Biliary tube removal was achieved at follow-up in 76.0% of patients who underwent PEHL and 66.3% of those who underwent PLL, a difference without statistical significance (P = .173). Conclusions: Procedural success, clinical success, AE rate, and biliary tube removal rate associated with PEHL and PLL in the treatment of biliary stones were not significantly different on analysis of the studied registry population.