ESWL experience in the therapy of difficult bile duct stones

Dig Dis Sci. 1996 Dec;41(12):2397-403. doi: 10.1007/BF02100134.


In recent years, alternatives to surgery for difficult bile duct stones have been developed. Routine endoscopy fails in about 10% of patients. To verify the role of extracorporeal shock wave lithotripsy in residual CBD stones, we treated 32 patients by HM4 or MPL 9000 Dornier lithotripters. Ten (34.4%) patients needed two extracorporeal shock wave lithotripsy sessions, and 3 (10.3%) patients three. Complete clearance was achieved in 29 patients (90.6%) after one or more sessions either by endoscopic (20 pts) or percutaneous (9 pts) extraction of the debris; of the remaining 3 patients, in 2 a bilioduodenal stent was placed and in 1 electrohydraulic lithotripsy was performed. Eighteen and seven-tenths percent transient mild hemobilia, 12.5% microhematuria, and no mortality were observed. It is possible to state that in site- or size-related difficult biliary stones, extracorporeal shock wave lithotripsy is a rapid, safe, and highly effective treatment as an additional nonoperative option to resolve the failure of routine endoscopic measures.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bile Duct Diseases / blood
  • Bile Duct Diseases / diagnosis
  • Bile Duct Diseases / therapy*
  • Bilirubin / blood
  • Cholelithiasis / blood
  • Cholelithiasis / diagnosis
  • Cholelithiasis / therapy*
  • Evaluation Studies as Topic
  • Female
  • Health Care Costs
  • Humans
  • Italy
  • Length of Stay
  • Lithotripsy* / adverse effects
  • Lithotripsy* / economics
  • Male
  • Middle Aged
  • Recurrence
  • Treatment Outcome


  • Bilirubin