Biological effects of biliary shock wave lithotripsy in swine

Extracorporeal shock waves generated with an electromagnetic lithotriptor of the second generation were administered to the gallbladder or bile ducts of 24 domestic piglets. In six animals, fresh human cholesterol gallstones were implanted into the gallbladder two weeks before shock wave administration. Treatment with 3,000 shock waves resulted in fragmentation of the majority of the gallstones in all six animals. In the other animals, 3,000 shock waves (n = 12) or 6,000 shock waves (n = 6) were directed at the gallbladder or the bile ducts without previous stone implantation. Twelve of all 24 animals were killed immediately after shock wave treatment, the other 12 after one week. Autopsy in all 24 animals revealed no gross traumatic changes; the peritoneal fluid was clear in all 24 animals. Microscopically, acute hemorrhage was found in the gallbladder wall (3/12 animals) or in the portal fissure and right lung base (1/12 animals) in those animals who were killed immediately. After one week, resolving hemorrhage with scar formation was found in the right or left lung base in 2/12 animals.