Buxbaum J, et al. - The physicians performed this randomized trial to compare the efficacy of cholangioscopy-guided laser lithotripsy vs. conventional therapy for large bile duct stones. As compared to conventional therapy alone, cholangioscopy-guided laser lithotripsy increased the incidence of endoscopic clearance of large bile duct stones and decreased the need for surgery. It was, however, correlated with longer procedure times.