Intracorporeal lithotripsy in the management of biliary stone disease

Choledocholithiasis accounts for approximately 4% to 10% of patients with biliary tract disease. The incidence of intrahepatic biliary disease is less common in the Western world and greater in Asian countries. The overwhelming majority of patients are treated by means of peroral endoscopy. In expert hands, standard techniques will clear the biliary tree from stones in approximately 90% of patients. However, 10% will require nonstandard management, including peroral or percutaneous mechanical, electrohydraulic, or laser lithotripsy. Very few patients will necessitate surgical intervention. Following is a review of the current status of intracorporeal lithotripsy, including principles and techniques, peroral and percutaneous applications, and its overall success.