Electrohydraulic lithotripsy of intrahepatic stones during choledochoscopy

In two patients, electrohydraulic lithotripsy was used under direct vision during choledochoscopy to fragment intrahepatic calculi above bile duct strictures, which were difficult to remove by ordinary choledochoscopic methods. Choledochoscopy was performed after dilation of a percutaneous transhepatic tract in one patient and after intubation of the subcutaneous blind jejunal limb of a previous Roux-en-Y intrahepatic cholangiojejunostomy in the other. Both patients were treated without any complications. Electrohydraulic lithotripsy during choledochoscopy is a safe and effective method to fragment stones and facilitate their removal.