Extracorporeal shock-wave lithotripsy in the management of bile duct stones

La, Fried; LeBrun, G. Paul; Rw, Norman; Db, Fraser; Mb, Taylor; Roy, P. Deb; Marshall, J C

doi:10.2214/ajr.151.5.923

Cited by 16 publications

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References 14 publications

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“…Adjunctive measures such as endoscopic extraction or nasobiliary Jrain with lavage are useJ routinely to ohtain satisfactory stone clearance rates. It is the only treatment required in approx 1mately 50% of cases (7,11).…”

Section: Discussionmentioning

confidence: 99%

Crushing Stones: Mechanical, Intracorporeal and Extracorporeal Lithotripsy in the Clearance of Common Bile Duct Lithiasis

Liguory

Lefebevre

Bonnel

et al. 1990

Canadian Journal of Gastroenterology

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Mechanical, intracorporeal and extracorporeal lithotnpsy were used in the treatment of common bile duct lirhiasis in a series of 80 patients in whom initial extraction attempts with the Dorrnia basket and balloon catheter failed. Mechanical lithotripsy was performed in 74 cases and was successful in 38 (51.3%). Among the 36 patients with failure of mechanical lithotripsy, five had an initial attempt at stone dissolution w1th methyl terr-butyl ether (MTBE) infused through a nasohiliary stent. This was successful in four cases; the stones did not disappear completely -however, they were smaller and easier to extract. Of the remaining 32 patients who failed mechanical lithotripsy, two underwent success[, l surgical stone extraction with no further attempts at nonoperative treatment and 30 underwent complementary shock wave lithotripsy. Extracorporeal lithotripsy was used in 19 of these patten ts. The intracorporeal lithotripsy group of21 patients comprised 11 with failed mechanical lithotripsy, six in whom no ocher treatment was attempted and four in whom exrracorporeal lithotripsy had failed. Excracorporeal lithocripsy was successful in 15 cases (79%) and intracorporeal lithotripsy in 19 (90%). There were four treatment failures, with one patient death due to cholangitis and respiratory failure. In summary, mechanical lithotripsy is an effective and safe treatment modality but has a high failure rate. Extracorporeal lithotripsy is useful and should he attempted where available, but is not always successful. Intracorporeal lithotripsy is very efficient but requires either the trampapillary route, which is cechmcally difficult, or the transhepatic route which carries associated complications. Can J Gastroenterol 1990;4(9):628-631

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Section: Discussionmentioning

confidence: 99%

Crushing Stones: Mechanical, Intracorporeal and Extracorporeal Lithotripsy in the Clearance of Common Bile Duct Lithiasis

Liguory

Lefebevre

Bonnel

et al. 1990

Canadian Journal of Gastroenterology

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Extracorporeal shockwave lithotripsy for common bile duct stones

Gilchrist¹,

Ross²,

Thomas³

1997

Br. J. Surg.

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Fragmentation of bile duct stones by extracorporeal shock-wave lithotripsy: A five-year experience

et al. 1992

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Over 5 yr, 103 elderly patients (mean age = 70 yr) with bile duct stones (mainly not amenable to endoscopic extraction) underwent adjuvant extracorporeal shock-wave lithotripsy using a first-generation kidney lithotripter. Disintegration of stones was achieved after a mean of 1.4 sessions in 92% of the patients. Spontaneous passage of fragments into the duodenum occurred in one fourth of the patients, and endoscopic extraction of fragments was necessary in 75% of the patients, resulting in complete clearance of the bile duct stones in 91 (88%) of 103 patients. The most important adverse effect was septic disease after extracorporeal shock-wave lithotripsy in 4% of the patients. The 30-day mortality rate was 1% (one patient), and another 15 patients died during a mean follow-up of 26 +/- 14 mo (mainly of causes unrelated to biliary tract disease). Two of 91 patients who had been rendered stone free were readmitted because of recurrent stone disease during the follow-up period. Of the 43 patients who still had their gallbladders during extracorporeal shock-wave lithotripsy, 14% subsequently underwent cholecystectomy. These data show that extracorporeal shock-wave lithotripsy of bile duct stones is a useful and safe adjunct to nonsurgical procedures for the removal of calculi in the biliary tree.

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Extracorporeal shock-wave lithotripsy in the management of bile duct stones

Cited by 16 publications

References 14 publications

Crushing Stones: Mechanical, Intracorporeal and Extracorporeal Lithotripsy in the Clearance of Common Bile Duct Lithiasis

Crushing Stones: Mechanical, Intracorporeal and Extracorporeal Lithotripsy in the Clearance of Common Bile Duct Lithiasis

Extracorporeal shockwave lithotripsy for common bile duct stones

Fragmentation of bile duct stones by extracorporeal shock-wave lithotripsy: A five-year experience

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