Summary
Extracorporeal piezoelectric lithotripsy (EPL) was performed in 12 patients with large-bile-duct stones and intrahepatic stones. The Piezolith 2300 lithotripter (Wolf, Knittlingen, FRG) was used in all patients in whom routine endoscopic approaches for removal of the calculi had failed or were considered inappropriate because of large stone size or difficult localization. In 9 of the 12 patients the stones were fragmented. Complete stone clearance from the bile ducts was obtained in 8 of 10 patients by EPL alone or combined with one of the following: endoscopic extraction, mechanical lithotripsy or installation of solvents. Adjuvant EPL in conjunction with endoscopic therapy increased the success rate of nonsurgical treatment for bile duct stones from 73% to 95%. No clinically significant side effects or complications were noted.
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Bühler H, Jaeger P, Ammann R, Hauri D, Knönagel H, Münch R, Siegenthaler W (1988) Extracorporale Stoßwellenlithotripsie (ESWL) zur Behandlung von Gallengangssteinen. Schweiz Med Wochenschr 118: 113–117
Cotton PB (1984) Endoscopic management of bile-duct stones (apples and oranges). Gut 25: 587–597
Doyle PY, Ward-McQuaid JN, McEwen Smith A (1982) The value of routine per-operative cholangiography — a report of 4000 cholecystectomies. Br J Surg 69: 617–619
Fried LA, Lebrun GP, Norman RW, Fraser DB, Taylor MC, Roy PD, Marshall JC (1988) Extracorporeal shock-wave lithotripsy in the management of bile duct stones. AJR 151: 923–926
Glenn F (1975) Trends in surgical treatment of calculus disease of the biliary tract. Surg Gynecol Obstet 140: 877–884
Lux G, Ell CH, Hochberger J, Müller D, Demling L (1986) The first successful endoscopic retrograde laser lithotripsy of common bile duct stones in man using a pulsed neodynium-YAG laser. Endoscopy 18: 144–145
Neoptolemos JP, Hofmann AF, Moossa AR (1986) Chemical treatment of stones in the biliary tree. Br J Surg 73: 515–524
Riemann JF, Demling L (1983) Lithotripsy of bile duct stones. Endoscopy 15: 191–196
Riemann JF, Seubert K, Demling L (1982) Clinical application of a new mechanical lithotriptor for smashing common bile duct stones. Endoscopy 14: 226–230
Sauerbruch T, Holl J, Sackmann M (1987) Treatment of bile duct stones by extracorporeal shock waves. Semin Ultrasound CT MR 8: 155–161
Sauerbruch T, Stern M, the Study Group for Shock-Wave Lithotripsy of Bile Duct Stones (1989) Fragmentation of bile duct stones by extracorporeal shock-waves. A new approach to biliary calculi after failure of routine endoscopic measures. Gastroenterology 96: 146–152
Staritz M, Floth A, Rambow A, Wilbert D, Meyer zum Büschenfelde KH (1987) Behandlung großer Gallengangssteine durch extrakorporale Stoßwellenlithotripsie (ESL) mit einem Gerät der zweiten Generation. Z Gastroenterol 25: 570–576
Tanaka M, Yoshimoto H, Ikeda S, Matsumoto S, Xuan GR (1985) Two approaches for electrohydraulic lithotripsy in the common bile duct. Surgery 98: 313–318
Thistle JL, Carlson GL, Hofmann AF, LaRusso NF, MacCarty RL, Flynn GL, Higuchi WI, Babayan VK (1980) Monooctanoin, a dissolution agent for retained cholesterol bile duct stones: physical properties and clinical application. Gastroenterology 78: 1016–1020
Vellacott KD, Powell PH (1979) Exploration of the common bile duct: a comparative study. Br J Surg 66: 389–391
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Kohlberger, E.J., Rädecke, J., Salm, R. et al. Large-bile-duct stones — extracorporeal piezoelectric lithotripsy as adjuvant measure for endoscopic basket extraction. Surg Endosc 4, 20–22 (1990). https://doi.org/10.1007/BF00591407
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DOI: https://doi.org/10.1007/BF00591407