The value of extracorporeal shock-wave lithotripsy in the management of bile duct stones.

Lee, S H; Fache, J S; Burhenne, H J

doi:10.2214/ajr.155.4.2119107

Cited by 17 publications

(5 citation statements)

References 15 publications

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“…Previous studies have reported clearance rates varying from 40% (two of five patients)9 to 67% (six of nine)20 in patients with intrahepatic stones treated with ESWL. In this study, stone clearance was achieved in all nine cases with intrahepatic stones.…”

Section: Discussionmentioning

confidence: 88%

Clearance of refractory bile duct stones with extracorporeal shockwave lithotripsy

Ellis

Jenkins

Thompson

et al. 2000

Gut

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Background-Extracorporeal shockwave lithotripsy (ESWL) has been used since the mid-1980s to fragment bile duct stones which cannot be removed endoscopically. Early machines required general anaesthesia and immersion in a waterbath. Aims-To investigate the eVectiveness of the third generation Storz Modulith SL20 lithotriptor in fragmenting bile duct stones that could not be cleared by mechanical lithotripsy. Methods-Eighty three patients with retained bile duct stones were treated. All patients received intravenous benzodiazepine sedation and pethidine analgesia. Stones were targeted by fluoroscopy following injection of contrast via a nasobiliary drain or T tube. Residual fragments were cleared at endoscopic retrograde cholangiopancreatography. Results-Complete stone clearance was achieved in 69 (83%) patients and in 18 of 24 patients (75%) who required more than one ESWL treatment. Stone clearance was achieved in all nine patients (100%) with intrahepatic stones and also in nine patients (100%) referred following surgical exploration of the bile duct. Complications included six cases of cholangitis and one perinephric haematoma which resolved spontaneously. Conclusion-Using the Storz Modulith, 83% of refractory bile duct calculi were cleared with a low rate of complications. These results confirm that ESWL is an excellent alternative to surgery in those patients in whom endoscopic techniques have failed. (Gut 2000;47:728-731)

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Section: Discussionmentioning

confidence: 88%

Clearance of refractory bile duct stones with extracorporeal shockwave lithotripsy

Ellis

Jenkins

Thompson

et al. 2000

Gut

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“…Extracorporeal shock-wave lithotripsy (ESWL) has been put forward as a non-surgical method of treating bile duct stones where alternative methods are unsuccessful. 37 ESWL has an advantage over other forms of stone treatment in that direct contact with the stone is not necessary. All patients should have a sphincterotomy prior to ESWL to allow clearance of residual small stone fragments.…”

Section: Extracorporeal Shock-wave Lithotripsymentioning

confidence: 99%

“…General anesthesia or intravenous sedation is generally necessary. 37 ESWL is not, however, approved for general use in the treatment of choledocholithiasis in the United States.…”

Section: Extracorporeal Shock-wave Lithotripsymentioning

confidence: 99%

Radiologic Management of Problematic Biliary Calculi

Vanderburgh¹,

Yeung²,

Ho³

1996

Semin intervent Radiol

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“…This method of treatment clears retained bile duct stones in 60-90% of patients, although some patients require repeated treatments. [16][17][18][19][20][21] Mortality associated with ESWL ranges from 0-2%. Major adverse effects are uncommon even in the elderly.…”

Section: Mechanical Lithotripsymentioning

confidence: 99%

“…Major adverse effects are uncommon even in the elderly. [16][17][18][19][20][21] Cost is the major drawback with ESWL, particularly as there are several cheap and equally effective non-surgical alternatives. Furthermore, capital investment in ESWL is becoming even less attractive because laparoscopic cholecystectomy is rapidly reducing the indications for ESWL in biliary disease in general.…”

Section: Mechanical Lithotripsymentioning

confidence: 99%