Mechanical lithotripsy of large gallstones: correlation with CT characteristics

The CT characteristics of gallstones were correlated with mechanical forces required to fragment calculi in vitro. Forty-two gallstones > or = 11 mm in largest diameter were subjected to in vitro CT scanning and categorized as isodense, faint, laminated, rimmed, or dense as compared with saline. A mechanical lithotripter, attached to a dynamometer, was utilized simulating in vivo technique to accomplish lithotripsy. Significantly more force was required to fracture CT-dense (p < 0.02) and CT-rimmed (p < 0.05) gallstones than was required to fracture CT-isodense gallstones.