Biliary and pancreatic lithotripsy devices

Area of Science:

• Gastroenterology
• Endoscopic Procedures

Background:

• Lithotripsy fragments stones in biliary and pancreatic ducts.
• Conventional endoscopic removal is suitable for most stones.
• Lithotripsy is necessary for large, impacted, or irregular stones.

Purpose of the Study:

• Review devices and methods for biliary and pancreatic lithotripsy.
• Evaluate the efficacy, safety, and financial aspects of lithotripsy techniques.

Main Methods:

• Review of intracorporeal lithotripsy (mechanical, electrohydraulic, laser).
• Review of extracorporeal shock-wave lithotripsy (ESWL).
• Comparison of techniques including endoscopic papillary balloon dilation (EPBD).

Main Results:

• Mechanical lithotripsy (ML) is effective for difficult stones.
• Endoscopic papillary balloon dilation (EPBD) may reduce the need for ML and adverse events.
• Electrohydraulic lithotripsy (EHL) and laser lithotripsy are effective but often require specialized centers.
• ESWL is effective but may involve increased costs and coordination.

Conclusions:

• Multiple lithotripsy techniques exist with varying ease of use, generalizability, and cost.
• Lithotripsy is a safe and effective treatment for challenging biliary and pancreatic duct stones.