Extracorporeal shock-wave lithotripsy for bile duct calculi

American Journal of Surgery
D M WhiteR C Thirlby

Abstract

Bile duct calculi (BDC) can be cleared or treated with modern endoscopic techniques in most patients. However, large stones, bile duct strictures, or unusual anatomy may make endoscopic clearance difficult. The purpose of the present study was to determine the efficacy of extracorporeal shock-wave lithotripsy (ESWL) in treating patients with complicated BDC. Between 1989 and January 1995, 16 patients with BDC were treated at our institution with ESWL using a Dornier HM-3 lithotropter. The average age of patients was 62 years (range 32 to 88). Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and attempted stone extraction (100%), nasobiliary drainage (83%), and biliary stents (6%) were used prior to ESWL. Eleven patients (61 %) had solitary stones, ranging in diameter from 0.5 to 2.6 cm, whereas 7 patients had multiple stones, ranging in diameter from 0.5 to 5.0 cm. The indications for ESWL were stone impaction (56%), stone size (38%), and bile duct stricture (6%). The 16 patients received 27 ESWL treatments (mean = 2101 shock at 21 kV); with 4 patients (22%) requiring multiple treatments. Stone fragmentation was achieved in 94% of patients. All patients had ERCP performed post-ESWL, and only 2 (13%) pat...Continue Reading

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Citations

Mar 17, 2006·Current Treatment Options in Gastroenterology·Lee McHenry, Glen Lehman
Feb 23, 1999·The Medical Journal of Australia·C H Wriedt
Oct 1, 2009·The Indian Journal of Surgery·Rajendra Desai, Bahaman N Shokouhi
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May 10, 2002·Pediatric Transplantation·Rainer Ganschow

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