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. 1991;5(4):196-9.
doi: 10.1007/BF02653263.

Extracorporeal Shock-Wave Lithotripsy and Endoscopy: Combined Therapy for Problematic Bile Duct Stones

Affiliations

Extracorporeal Shock-Wave Lithotripsy and Endoscopy: Combined Therapy for Problematic Bile Duct Stones

C Harz et al. Surg Endosc. .

Abstract

Endoscopic treatment of bile duct stones is currently successful in 86% of patients. We prospectively studied the efficacy and complication rate of extracorporeal shock-wave lithotripsy (ESWL) of problematic bile duct stones combined with endoscopy. When stone removal was not possible, patients were subjected to ESWL. Fragmented stones were removed endoscopically. During 1 year, 220 patients presenting with choledocholithiasis were diagnosed and 188 were successfully treated endoscopically. In all, 3 subjects received alternative treatment and the remaining 29 (13%) constituted our study group; 19 (65%) were women and the mean age was 76.7 years. Overall, 22 (76%) were high-risk patients; 23 (79%) were jaundiced and 9 (31%) had cholangitis at admission. The most frequent indication for ESWL was stone size. Stone fragmentation was achieved in 80% of cases. Complications were mild and were managed conservatively. No patient died. Complete stone clearance was possible in 23 (80%) cases. The association of ESWL and endoscopy enhanced the success rate of endoscopic stone clearance from 86% to 96%. During the same period, open surgery was performed in 4 cases for residual common bile duct (CBD) stones and in 32 cases in association with simultaneous cholecystectomy.

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References

    1. Gut. 1984 Jun;25(6):587-97 - PubMed
    1. Gastroenterology. 1990 Oct;99(4):1128-33 - PubMed
    1. Br J Surg. 1986 Jul;73(7):515-24 - PubMed
    1. Gastroenterology. 1980 May;78(5 Pt 1):1016-22 - PubMed
    1. Surgery. 1985 Aug;98(2):313-8 - PubMed

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