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Medline ® Abstract for Reference 49

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

Clinical application of a new disposable lithotripter: a prospective multicenter study.
Sorbi D, Van Os EC, Aberger FJ, Derfus GA, Erickson R, Meier P, Nelson D, Nelson P, Shaw M, Gostout CJ
Gastrointest Endosc. 1999;49(2):210.
BACKGROUND: Mechanical lithotripsy has become a well-accepted method of bile duct stone fragmentation and removal. The Olympus lithotripter (Olympus American, Melville, NY) is the standard reusable lithotripter at the institutions that participated in this study. A disposable device with a preassembled pistol grip may perform equally well and facilitate operation.
METHODS: Twenty patients with bile duct stones were evaluated as part of a multicenter prospective study. Data were obtained regarding stone size and number, bile duct diameter, and configuration, ease of cannulation, basket function, stone capture and crushing success, and complications.
RESULTS: The maximum stone size averaged 16.5 +/- 1.2 mm (range 10 to 30 mm). Sixteen patients had multiple stones (median 5, range 2 to 12). The mean bile duct diameter was 20.5 +/- 1.5 mm (range 12 to 38 mm). Cannulation was successful in all within 5 attempts. Basket deployment failed in 1 patient because of stone size and the basket was misshapen in 14. Bile duct clearance was complete in 16 subjects (80%), incomplete in 2 patients, and failed in 2 patients. Abnormal duct configuration (sigmoid, stricture) was noted in 2 of 4 patients with failed capture and 7 of 16 patients with successful clearance. No statistically significant difference was observed between the bile duct diameter, maximum stone size, number of stones, and successful clearance.
CONCLUSION: The disposable lithotripter is easy to use and, compared with the published results for the reusable lithotripter, performs almost as well.
Mayo Clinic, Rochester; Gundersen Lutheran, LaCrosse, Wisconsin; Midelfort Clinic, Eau Claire, Wisconsin, USA.