[Biliary extracorporeal shockwave lithotripsy. Preliminary communication]

Shock wave lithotripsy has been successfully used in the treatment of urinary stones. Since 1985, it has also been applied in the management of gallbladder and biliary duct stones. The preliminary experience in Venezuela with the shock wave technology for the treatment of biliary stone disease is presented. The facilities of the Unit for the Treatment of Lithiasis. UNILIT of Venezuela, in Caracas were used. This unit is equipped with a Siemens Lithostar, that operates with an electromagnetic shock wave generator guided by a very accurate computerized biplane fluoroscopic system. Symptomatic gallstones with functioning gallbladder and radiolucid stones smaller than 3 cm, were the most important inclusion criteria. For duct stones, all cases that could not be managed by endoscopy were included. Fifteen cases have been treated from April 1988. Ten with gallstones and 5 with biliary duct stones. Success rate for gallstones, clarifications of gallbladder within a 12 month follow-up, was achieved in 40%. In the cases of biliary duct lithiasis, the aim was to reduce the stone to smaller fragments that could pass spontaneously or be retrieved by endoscopic maneuvers. In all the five cases treated, the stones could be crushed into small fragments and in four, they were easily withdrawn by endoscopic ballooning. Preliminary results and published data suggest that shockwave lithotripsy is a valuable method of treatment for selected cases of gallbladder stones and it is specially useful in the management of biliary duct stones where the endoscopic maneuvers have failed.