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Related Experiment Videos

[Extracorporeal shock wave lithotripsy for choledocholithiasis].

Y Otani1, Y Tanaka, K Goto

  • 1Second Department of Surgery, School of Medicine, Tokai University, Isehara, Japan.

Nihon Geka Gakkai Zasshi
|September 1, 1992
PubMed
Summary

Extracorporeal shock wave lithotripsy (ESWL) offers a safer alternative to endoscopic sphincterotomy (EST) for treating bile duct stones. Combining ESWL with biliary drainage procedures like endoscopic naso-biliary drainage (ENBD) or percutaneous transhepatic biliary drainage (PTBD) achieved high success rates.

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Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery
  • Biliary Tract Interventions

Context:

  • Choledocholithiasis management has evolved with extracorporeal shock wave lithotripsy (ESWL).
  • Endoscopic sphincterotomy (EST) is common but carries risks.
  • ESWL presents a less invasive option with fewer complications compared to EST.

Purpose:

  • To evaluate the efficacy of ESWL combined with biliary drainage for choledocholithiasis.
  • To assess the safety and outcomes of ESWL without EST, preserving papilla Vater function.
  • To report on the use of endoscopic naso-biliary drainage (ENBD) and percutaneous transhepatic biliary drainage (PTBD) prior to ESWL.

Summary:

  • This study reports on 42 patients with choledocholithiasis treated with ESWL after initial biliary drainage (ENBD or PTBD).

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  • Choledocholithiasis was completely cleared in 73.8% (31/42) of cases.
  • Unsuccessful treatments were managed with EST, percutaneous transhepatic cholangioscopy (PTCS), or laparotomy.

    • Impact:

    • ESWL, when used with biliary drainage, demonstrates a high success rate for choledocholithiasis.
    • This approach offers a safer, less invasive alternative to traditional EST.
    • Preservation of papilla Vater function is a key benefit of this combined technique.