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Related Experiment Videos

The intercostal pathway for biliary lithotripsy: an evaluation.

D E Malone1, B Rawat, J S Fache

  • 1Department of Radiology, University of British Columbia, Vancouver, Canada.

Radiology
|February 1, 1990
PubMed
Summary
This summary is machine-generated.

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Intercostal biliary extracorporeal shock wave lithotripsy (BESWL) is a viable alternative for gallstones when the subcostal approach is not feasible. This study found intercostal BESWL effectively fragmented gallstones in all patients.

Area of Science:

  • Gastroenterology
  • Medical Devices
  • Urology

Background:

  • Gallstones in retrocostal locations pose challenges for standard extracorporeal shock wave lithotripsy (BESWL).
  • The intercostal pathway offers a potential alternative for accessing these difficult-to-target gallbladders.

Purpose of the Study:

  • To evaluate the safety and efficacy of intercostal biliary extracorporeal shock wave lithotripsy (BESWL).
  • To determine the feasibility of the intercostal approach for gallstone fragmentation when subcostal BESWL is not suitable.

Main Methods:

  • A three-stage study involving animal models (pigs) and human patients.
  • Assessment of histologic changes in pigs and clinical outcomes, including gallstone fragmentation and adverse events, in patients.

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Main Results:

  • No macroscopic abnormalities were observed in pigs; minor microscopic hemorrhages occurred in two.
  • Intercostal BESWL successfully fragmented all targeted gallstones across all study stages.
  • Minor adverse events in patients included contact-site tenderness and transient aspartate aminotransferase elevations.

Conclusions:

  • The intercostal pathway is a safe and effective alternative for biliary extracorporeal shock wave lithotripsy (BESWL).
  • This approach is particularly valuable when the standard subcostal route is unsatisfactory for gallstone treatment.