[Extracorporeal lithotripsy in combination with endoscopic papillotomy in choledocholithiasis]

Results of treatment of 30 patients of 50 to 90 years of age having choledocholithiasis by the method of extracorporeal lithotripsy (EL) combined with endoscopic operations on the major duodenal papilla are described. The first stage in the treatment was endoscopic papillosphincterotomy. There were 41 sessions of EL (at an average 1,37 procedure for each patient). In 15 patients spontaneous excretion of the fragments from the common bile duct was noted. The endoscopic sanitation of the common bile duct with a removal of fragments with the Dormia basket was fulfilled in 13 patients after EL. The method of choledocholithotomy proved to be ineffective in 2 patients. Sanitation of the common bile duct was performed in all the patients before their discharge from the hospital. Thus the results obtained allow considering the extracorporeal biliary lithotripsy when combined with endoscopic papillosphincterotomy as an effective method for treatment of patients with choledocholithiasis which not only supplements traditional surgical procedures but also may be used as an alternative method of treatment especially for patients with high operative risk.