Treatment of retained cystic duct stones using extracorporeal shockwave lithotripsy

Extracorporeal Shock-Wave Lithotripsy of a Large Common Bile Duct Stone: Report of a Case

“…With the patient immersed in water, shock waves were generated by a current under water spark discharge and focused on the gallstones with the aid of ultrasound. At first, general anesthesia was used, but this was later replaced by either epidural 10 or intravenous 11 analgesia. Stones were fragmented in all but two patients and disappeared between 2 and 24 months.…”

New Approaches to Common Bile Duct Calculi - Roles of MethylTert-Butyl Ether, Monooctanoin, and Mechanical Fragmentation

“…39 Therefore, although recognizing that common bile duct calculi and gallstones may be slightly dissimilar in structural and chemical composition, we expect that methods that penetrate or fragment the stone's shell and matrix will expose the underlying cholesterol to solvents and thus hasten the dissolution process. Extracorporeal shock wave lithotripsy, 40,41 lasers, and percutaneous pulverization with high-speed rotational catheters 42 are quite capable of fragmenting common duct calculi, and their use in combination with the contact cholesterol solvents (monooctanoin and MTBE) as well as the long-term use of oral agents (ursodeoxycholic and chenodeoxycholic acids) to prevent stone recurrence looks promising.…”

Laparoscopic management of common bile duct stones: Study of 13 cases

“…There are several options for the removal of common bile duct (CBD) stones: (1) endoscopic sphincterotoym (EST) followed by a stone extraction technique,1,2 (2) percutaneous transhepatic cholangiodrainage (PTCD) accompanied by percutaneous transhepatic cholangioscopic lithotripsy (PTCSL),3 (3) extracorporeal shock wave lithotripsy (ESWL),4,5 and (4) open surgical lithotripsy. Laparoscopic cholecystectomy (LC)6 has now become the standard treatment for gallbladder disease, and the removal of CBD stones has been included in the indications for laparoscopic management 7.…”