Treatment of difficult bile duct stones using mechanical, electrohydraulic and extracorporeal shock wave lithotripsy.

摘要: Over a 34-month period (1989-1991), 791 patients were diagnosed at endoscopic retrograde cholangiography to have bile duct stones. All underwent sphincterotomy and attempted extraction by Dormia basket. This was successful in 683 (86%). The remaining 108 with "difficult stones" (mean age 72 years) mechanical, electrohydraulic or extracorporeal shock wave lithotripsy according the following algorithm: (1) Mechanical for stones which could not be extracted after entrapment basket (n = 33); (2) peroral cholangioscopic engaged 65); (3) intrahepatic 10). Stone fragmentation clearance all treated mechanical lithotripsy, unsuccessful one patient submitted due inability insert cholangioscope into failed 3 lithotripsy. Overall, 95% of difficult refractory conventional removed using above techniques. There no serious procedure-related complications.