Factors influencing the effectiveness of extracorporeal shock-wave lithotripsy of biliary duct calculi.
The authors examined the effectiveness of extracorporeal shock-wave lithotripsy on patients who had bile-duct stones. Thirty-eight patients were treated with an unmodified HM-3 Dornier lithotripter; 35 (92%) patients either passed the stone fragments spontaneously or had them reduced to a size which allowed removal by percutaneous or endoscopic techniques. As stone size increased so did the number of shocks required for satisfactory fragmentation, the number of treatments and the rate of post-treatment manipulation. The number of stones was not as important a variable as the authors expected. Pre-treatment sphincterotomy was not always necessary and was of no benefit in terms of spontaneous passage of fragments. Complications were minor. Extracorporeal shock-wave lithotripsy of stones throughout the biliary tree is a safe, effective and invaluable adjunct in the management of bile-duct stones.
Norman
R W
RW
Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS.
Fried
L A
LA
LeBrun
G P
GP
Taylor
M C
MC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002769:Cholelithiasis / Q000628:therapy*; D003967:Diarrhea / Q000209:etiology; D005260:Female; D006801:Humans; D008096:Lithotripsy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011379:Prognosis