Extracorporeal shock wave lithotripsy of common bile duct stones in patients with increased operative risk

Eur J Surg. 1994 Jan;160(1):31-5.


Objective: Assessment of efficacy of extracorporeal shock wave lithotripsy (ESWL) of stones in the common bile duct.

Design: Prospective clinical study.

Setting: Department of Surgery, University Hospital Rotterdam, Rotterdam, The Netherlands.

Subjects: 90 patients with stones in the common bile duct and at increased operative risk (median age 73 years, range 27-95).

Interventions: After failure of endoscopic measures, the first 13 patients were treated under general anaesthesia with a first generation lithotriptor. Of the next 77 patients, treated with a second generation lithotriptor, only one required general anaesthesia and 68 intravenous analgesia and sedation. Eight patients needed no analgesia at all.

Main outcome measures: Fragmentation, clearance, and recurrence of stones.

Results: Fragmentation of stones was achieved in all the first 13 patients and 63 of the 90 patients (69%). There were minor complications (macroscopic haematuria and subcapsular haematoma of the right kidney) in 13 and serious complications (bacteraemia) in 2. At follow-up (median 28 months), 2 patients had recurrent stones.

Conclusion: ESWL of stones in the common bile duct is safe and effective and should be considered in high risk patients.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Evaluation Studies as Topic
  • Female
  • Follow-Up Studies
  • Gallstones / therapy*
  • Humans
  • Lithotripsy*
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk
  • Treatment Outcome