Anaesthetic experience with percutaneous lithotripsy. A review of potential and actual complications

Percutaneous lithotripsy has evolved over the last several years as a procedure for removing renal calculi via percutaneous puncture of the renal collecting system. This article reviews our initial anaesthetic experience with 48 procedures and identifies both actual and potential complications. The most significant complication identified is instillation of large volumes of irrigation fluid into the retroperitoneal space. Two cases of metabolic acidosis and abdominal distension are presented. One responded to treatment while the other progressed to a fatal disseminated intravascular coagulopathy. Recommendations to prevent this are given.