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Medline ® Abstract for Reference 47

of 'Endoscopic management of bile duct stones: Standard techniques and mechanical lithotripsy'

Mechanical lithotripsy of large common bile duct stones.
Van Dam J, Sivak MV Jr
Cleve Clin J Med. 1993;60(1):38.
Endoscopic removal of biliary calculi is a safe and effective alternative to surgical exploration of the common bile duct. However, as stones increase in diameter, endoscopic retrieval becomes more difficult and hazardous. Mechanical lithotripsy is an endoscopic technique used to crush common bile duct stones that are too large to be removed by conventional methods. In the 3 years following the introduction of this technique at our institution, 145 patients underwent endoscopic retrograde cholangiopancreatography for symptomatic choledocholithiasis. Endoscopic mechanical lithotripsy improved the overall success rate of common bile duct clearance from 86.2% to 94.5%. No morbidity or mortality was associated with the procedure. Therefore, we recommend mechanical lithotripsy when bile duct stones cannot be removed with conventional techniques.
Department of Gastroenterology, Cleveland Clinic Foundation, OH 44195.