The Current Place of Shock-Wave Lithotripsy for Bile Duct Stones

Sauerbruch T, Stern M. (1989) Fragmentation of bile duct stones by extracorporeal shock waves: A new approach to biliary calculi after failure of routine endoscopic measures. Gastroenterology, Vol. 96:146-152 A prospective uncontrolled multicenter trial was performed on 113 patients with bile duct stones in whom routine endoscopic approaches for removal of the calculi had failed. These represented 8.3% of the patients referred to the participating centers for endoscopic extraction of the stones. Extracorporeal shock-wave lithotripsy using the Dornier kidney lithotripter achieved stone disintegration in 103 patients (91%). Complete stone clearance from the bile ducts was obtained in 97 patients (86%) after a median of 4 days following extracorporeal shock-wave lithotripsy. Adverse effects, mostly mild, occurred in 36% of the patients. A 30-day mortality rate of 0.9% (inhospital mortality rate 1.8%) of this high-risk group with a mean age of 72 yr and a cholangitis rate of 26%, compared favorably with the data given for open surgery. We therefore consider extracorporeal shock-wave lithotripsy a useful method for the treatment of bile duct stones not amenable to routine endoscopic measures 218 HPB INTERNATIONAL Reprinted with permission from the authors of the above article from the journal Gastroenterology. Copyright 1989 by the American Gastroenterological Association.