Abstract
Extracorporeal shock wave lithotripsy has revolutionized the management of upper urinary tract stones. Its success and safety have led to a proliferation of machines and of urologists trained in their use. Therefore, it is not surprising that at some institutions, urologists have been asked to apply their expertise to fragment biliary calculi. We have successfully treated 11 patients with retained (post-cholecystostomy or post-cholecystectomy) gallstones in the cystic, hepatic, or common bile ducts using an unmodified Dornier HM3 lithotripter. All patients were initially operated upon by general surgeons and were subsequently evaluated by interventional radiologists. All stones underwent unsuccessful percutaneous or endoscopic manipulation or were considered inappropriate for such procedures because of size or location. In each case imaging was possible by introducing contrast material through the cholecystostomy tube, a nasobiliary catheter, or a T-tube. Following cholelithotripsy, all patients either passed the fragments or had them reduced to a size that could be removed by percutaneous or endoscopic techniques. No complications were encountered. Because the number of situations in which ESWL can be used is limited, it may be difficult for physicians other than urologists to acquire and maintain the skills necessary to operate the lithotripter. Until specific biliary lithotripters become widely available, urologists may continue to be asked to assist in the management of patients requiring extracorporeal shock wave cholelithotripsy.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Skucas J: Diagnostic and interventional radiology. In Schwartz SI and Ellis H (eds): Maingof’s Abdominal Operations, Eighth Edition. London: Appleton-Century-Crofts, 1985.
Sauerbruch T, Delius M, Paumgartner G, et al: Fragmentation of gallstones by extracorporeal shock waves. NEJM 314: 818, 1986.
Gelfand DW, McCullough DL, Myer RT, et al: Choledocholithiasis: successful treatment with extracorporeal lithotripsy. AJR 148: 1114, 1987.
Becker CD, Fache JS, Gibney RG, et al: Treatment of retained cystic duct stones using ESWL. AJR 148: 1121, 1987.
Becker CO, Nagy AG, Fache JS, et al: Obstructive jaundice and cholangitis due to choledocholithiasis: treatment by extracorporeal Shock wave lithotripsy. Can J Surg 30: 418, 1987.
Sackmann J, Weber W, Delius M, et al: Extracorporeal shock wave lithotripsy of gallstones without general anesthesia: first clinical experience. Ann Int Med 107: 347, 1987.
Ferucci JT: Biliary lithotripsy: what will the issues be? AJR 149: 227, 1987.
Berhenne HF: The promise of ESWL for the treatment of gallstones. AJR 233, 1987.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1988 Springer Science+Business Media New York
About this chapter
Cite this chapter
Norman, R.W., Fried, L.A., LeBrun, G.P., Taylor, M.C. (1988). Extracorporeal Shock Wave Cholelithotripsy. In: Lingeman, J.E., Newman, D.M. (eds) Shock Wave Lithotripsy. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-1977-2_43
Download citation
DOI: https://doi.org/10.1007/978-1-4757-1977-2_43
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4757-1979-6
Online ISBN: 978-1-4757-1977-2
eBook Packages: Springer Book Archive