title: Piezoelectric extracorporeal shockwave lithotripsy for bile duct stone formation after choledochal cyst excision.
abstract: We report a case of bile duct stones in which piezoelectric extracorporeal shockwave lithotripsy (ESWL) was highly effective for the clearance of stones. A 16-year-old girl, who had undergone excision of a choledochal cyst when she was 3 years old, presented a spiking fever and colic abdominal pain. Radiological investigations showed two large stones incarcerating to the proximal end of hepatico-jejunostomy anastomosis. Massive debris was also present in intrahepatic bile duct proximal to the anastomosis. She underwent piezoelectric ESWL with an EDAP LT02 lithotripter. An average of 40 min ESWL session was repeated at intervals of 2 or 3 days. Neither anesthetic nor sedative treatment was required. By the end of the sixth session, the stones incarcerated were fragmented and the debris in the intrahepatic bile duct was completely eliminated. We conclude that piezoelectric ESWL is a less invasive, effective and repeatable method, therefore, it could be a treatment of choice for bile duct stone formation after choledochal cyst excision.
authors: Department of Paediatric Surgery, Toyama City Hospital, Imaizumi, Toyama, Japan. okada@tch.toyama.toyama.ac.jp
authors: Yasuhiro
authors: Y
authors: Okada
authors: Masatoshi
authors: M
authors: Miyamoto
authors: Toru
authors: T
authors: Yamazaki
authors: Isamu
authors: I
authors: Motoi
authors: Masato
authors: M
authors: Kuribayashi
authors: Koichi
authors: K
authors: Kodama
mesh_terms: D000293:Adolescent; D001653:Bile Ducts, Intrahepatic; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects*; D049448:Cholangiopancreatography, Magnetic Resonance; D015529:Choledochal Cyst / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D011183:Postoperative Complications; D014057:Tomography, X-Ray Computed