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The development of EST and percutaneous transhepatic catheterization techniques and recent improvements in fiberoptic cholangioscopy have allowed for non-surgical removal of biliary stones. Several centers have reported success in bile stone fragmentation and removal via percutaneously or via transpapillary using various techniques (mechanical stone extraction, ultrasonic lithotripsy, electrohydrauric lithotripsy, Nd : YAG laser). However, some reports have suggested the possibility of bile duct damage being associated with EHL or Nd : YAG laser treatment.

Endoscopic Lithotripsy of Bile duct stones by using a Pulsed-Dye Laser.