Laparoscopic treatment for gallbladder stones and the place of intracorporeal lithotripsy.

An ultrasonic lithotriptor (U.S. Olympus) introduced into the gallbladder under visual control of a laparoscope permits fragmentation of the stones and complete clearance of the gallbladder in one session of 10-20 min. The empty, clean gallbladder can be drained (cholecystostomy) or removed (cholecystectomy) by passing it through an 8-10 mm orifice of the abdominal wall. A series of 18 cholecystostomies and 200 cholecystectomies shows that intracorporeal lithotripsy prior to these procedures is efficient, safe, and elegant. It is the guarantee of a real laparoscopic procedure in cases of cholecystectomy.