Fragmentation of Biliary Calculi in 71 Patients by Use of Intracorporeal Electrohydraulic Lithotripsy

Kevin E. Burton, Daniel Picus, Marshall E. Hicks, Michael D. Darcy, Thomas M. Vesely, Michael A. Kleinhoffer, Giuseppe P. Aliperti, Steven A. Edmundowicz

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Failure of percutaneous or endoscopic removal of biliary calculi is often associated with impacted stones or stones larger than 1.5 cm. In these difficult cases, intracorporeal electrohydraulic lithotripsy (EHL) is a method that allows large stones to be fragmented and removed percutaneously or endoscopically. In this study, the authors expand their experience with EHL and further evaluate the safety and efficacy of this technique to remove biliary tract calculi. Intracorporeal electrohydraulic lithotripsy was used to treat 71 patients with calculi in the bile ducts (n = 35) or gallbladder (n = 36). Access was obtained by means of a surgical T-tube tract (n = 16), percutaneous transhepatic biliary drainage (n = 14), percutaneous cholecystostomy (n = 36), an intraoperative approach during common duct exploration (n = 2), and at endoscopic retrograde cholangiopancreatography (n = 3). EHL lithotripsy was effective in fragmenting all biliary stones in 69 of the 71 patients (97%). All of the stone fragments were removed in 67 of these 69 patients (94%). Major complications, including bile peritonitis and gallbladder necrosis, occurred in five patients; however, all major complications were related to the initial percutaneous drainage or tract dilation. No significant complications were directly attributable to the EHL procedure. Intracorporeal EHL is a safe and effective method that can be used to improve the success of percutaneous and endoscopic biliary calculi removal.

Original languageEnglish
Pages (from-to)251-256
Number of pages6
JournalJournal of Vascular and Interventional Radiology
Volume4
Issue number2
DOIs
StatePublished - Jan 1 1993
Externally publishedYes

Keywords

  • Bile ducts, calculi, 76.122, 76.289
  • Bile ducts, interventional procedures, 76.1223
  • Bile ducts, stone extraction, 76.1228
  • EHL
  • ERCP
  • ESWL
  • FDA
  • Food and Drug Administration
  • Gallbladder, calculi, 762.122, 762.289
  • Lithotripsy, 76.1223, 76.1228
  • MTBE
  • electrohydraulic lithotripsy
  • endoscopic retrograde cholangiopancreatography
  • extra-corporeal shock-wave lithotripsy
  • methyl tert-butyl ether

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