Extracorporeal shock-wave lithotripsy and the management of common bile-duct calculi.
Endoscopic sphincterotomy is the treatment of first choice for stones that remain in the bile duct after cholecystectomy. There is a small group of patients in whom this technique is not successful; many of these patients carry a high risk for surgery because of their age or associated medical conditions. A variety of non-surgical techniques is available; however, none is well established. We have used an in-vitro model to show that human gallstones are fragmented readily by shock-wave lithotripsy. Two elderly frail patients with difficult bile-duct stones have been treated successfully by extracorporeal shock-wave lithotripsy. The bile ducts were cleared of stones and the patients suffered no adverse effects. Extracorporeal shock-wave lithotripsy is a new and promising alternative to the current non-surgical techniques for the management of bile-duct stones.
Speer
A G
AG
Royal Melbourne Hospital, Parkville, VIC.
Webb
D R
DR
Collier
N A
NA
McHutchinson
J G
JG
St John
D J
DJ
Clunie
G J
GJ
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D042882:Gallstones / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D011859:Radiography