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Related Experiment Videos

Lithotripsy in the laparoscopic era.

Emanuele Lo Menzo1, Robert Schnall, David Von Rueden

  • 1Lankenau Hospital, Wynnewood, Pennsylvania, USA. ELoMenzo@hotmail.com

JSLS : Journal of the Society of Laparoendoscopic Surgeons
|August 27, 2005
PubMed
Summary

Electrohydraulic lithotripsy (EHL) effectively treated a retained common bile duct stone after two failed endoscopic procedures. This case demonstrates EHL as a viable option for challenging gallstone removal.

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Area of Science:

  • Gastroenterology
  • Endoscopic retrograde cholangiopancreatography (ERCP)
  • Interventional Endoscopy

Background:

  • Gallstones affect 10-15% of the US population.
  • Endoscopic sphincterotomy with basket/balloon extraction removes 85% of common bile duct (CBD) stones.
  • Mechanical lithotripsy improves CBD stone removal rates to 90%.

Observation:

  • A 50-year-old male presented with suppurative cholangitis and a retained CBD stone after failed ERCP.
  • Subsequent percutaneous balloon extraction via T-tube tract was also unsuccessful.
  • The patient developed mild pancreatitis due to the impacted distal CBD stone.

Findings:

  • A single 2.5-hour electrohydraulic lithotripsy (EHL) session via the T-tube tract successfully cleared the CBD stone.
  • Complete CBD clearance was achieved without requiring further ERCP.
  • Intraoperative mild pulmonary edema was the only complication.

Implications:

  • Electrohydraulic lithotripsy (EHL) is a valuable treatment for difficult retained CBD stones.
  • EHL offers an effective alternative when standard endoscopic extraction methods fail.
  • This approach can prevent the need for more invasive procedures in complex cases.

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