| Theme |
Treatment of Choledocholithiasis |
| Title |
Extracorporeal Shock Wave Lithotripsy for Bile Duct Stones |
| Author |
Hironao Miyoshi |
Department of Gastroenterology, Second Teaching Hospital, Fujita Health University School of Medicine |
| Author |
Kazuo Inui |
Department of Gastroenterology, Second Teaching Hospital, Fujita Health University School of Medicine |
| Author |
Satoshi Yamamoto |
Department of Gastroenterology, Second Teaching Hospital, Fujita Health University School of Medicine |
| Author |
Yoshiaki Katano |
Department of Gastroenterology, Second Teaching Hospital, Fujita Health University School of Medicine |
| [ Summary ] |
Endoscopic extraction of bile duct stones after sphincterotomy has a success rate of up to 80‒90 % with basket, balloon or mechanical lithotripsy. However, it is difficult to conduct the procedure in patients with large stones, bile duct strictures or a difficult anatomy. For such difficult stones, peroral or percutaneous cholangioscopy using electrohydraulic lithotripsy, endoscopic papillary large balloon dilation, single or double‒balloon, and EUS‒guided antegrade technique are performed. Moreover, extracorporeal shock wave lithotripsy (ESWL) can also be useful.
Stones were targeted by fluoroscopy following the injection of contrast via a nasobiliary drainage or percutaneous transhepatic biliary drainage. Complete clearance was achieved in 63.3 % to 90.2 % with ESWL conducted by endoscopic treatment, and 63.3 to 67.3 % with ESWL alone. The complications were reported in 9 % to 16 %, and most were mild. Therefore, ESWL is a safe and effective therapy for treating difficult bile duct stones. |