Intraductal laser sialolithotripsy: History of development and current state. Systematic review

Sialolithiasis is a common pathology of the salivary glands, for which traditional surgical treatment often results in irreversible functional impairment, negatively affecting the digestive tract as a whole. In this context, the development of minimally invasive, gland-preserving technologies is considered a promising alternative, one of which is intraductal laser sialolithotripsy. However, its widespread adoption is limited by the relatively high cost of the equipment, necessitating the creation of an evidence base that objectively confirms the clinical effectiveness of the method. Objective: To conduct a systematic review of the literature evaluating the efficacy and safety of intraductal laser sialolithotripsy in patients with sialolithiasis. Materials and methods. Publications from the RSCI, Medline (PubMed), and Google Scholar databases published between 1990 and 2025 were analyzed. Keywords related to sialolithiasis, sialendoscopy, and laser lithotripsy were used. Studies describing the intervention technique, clinical outcomes, and complications were included. A qualitative descriptive synthesis was performed. Results. Thirty-seven publications were included. The data indicate that laser sialolithotripsy enables stone fragmentation and alleviation of clinical symptoms. Holmium and thulium lasers are the most extensively studied. The method has advantages over mechanical lithotripsy; however, limitations remain, including the risk of duct perforation and stenosis, residual stone fragments, the need for repeated interventions, as well as the influence of stone location and procedure duration on outcomes. The evidence base is limited, and comparative prospective studies with other minimally invasive techniques are lacking. Conclusion: Intraductal laser sialolithotripsy is a promising gland-preserving treatment for sialolithiasis; however, it has certain limitations, underscoring the need for comparative randomized clinical trials to assess functional outcomes and long-term safety.