Electromagnetically generated extracorporeal shockwaves for fragmentation of extra-and intrahepatic bile duct stones: indications, success and problems during a 15 months clinical experience

• Published in: Gut 1990-02, Vol.31 (2), p.222-225
• Main Authors: Staritz, M, Rambow, A, Grosse, A, Hurst, A, Floth, A, Mildenberger, P, Goebel, M, Junginger, T, Hohenfellner, R, Thelen, M
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Bile Duct Diseases - diagnostic imaging; Bile Duct Diseases - therapy; Bile Ducts, Intrahepatic; Cholangiopancreatography, Endoscopic Retrograde; Cholelithiasis - diagnostic imaging; Cholelithiasis - therapy; Electromagnetic Phenomena; Female; Gallstones - diagnostic imaging; Gallstones - therapy; Humans; Lithotripsy - adverse effects; Lithotripsy - methods; Middle Aged
• ISSN: 0017-5749; 1468-3288; 1458-3288
• DOI: 10.1136/gut.31.2.222

Electromagnetically generated extracorporeal shock waves (without waterbath) were applied after intravenous premedication with 10-15 mg diazepam and 100 mg tramadol in the treatment of 33 patients (aged 32 to 91 years) with multiple intrahepatic stones (n = 4) or huge common bile duct stones (n = 29, 18-30 mm in diameter), which could not be removed by conventional endoscopy. Stone disintegration was achieved in 70% of common bile duct stones and in all intrahepatic concrements after 800-7500 discharges, which were applied during one (n = 21), two (n = 6) or three sessions (n = 6). Apart from mild fleabite-like petechiae at the side of shock wave transmission no other side effects were observed for a total of 51 procedures. We believe electromagnetically generated shock waves are safe, easy to apply, and relatively effective in the therapy of common bile duct and intrahepatic stones.