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Endoscopy 1996; 28(5): 411-417
DOI: 10.1055/s-2007-1005502
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Long-Term Follow-Up After Treatment of Common Bile Duct Stones by Extracorporeal Shock-Wave Lithotripsy

C. Meyenberger, U. Meierhofer, C. Michel-Harder, J. Knuchel, H. P. Wirth, H. Bühler, R. Münch, J. Altorfer
  • Dept. of Internal Medicine, Division of Gastroenterology, University Hospital, Zurich, Switzerland
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Publication Date:
17 March 2008 (online)

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Abstract

Background and Study Aims: The efficacy of extracorporeal shock-wave lithotripsy (ESWL) of difficult bile duct stones that were not amenable to routine endoscopic extraction was assessed, with evaluation of the long-term follow-up after successful treatment.

Patients and Methods: Fifty-four patients (mean age 74 years, range 33-92) were treated with ESWL for difficult bile duct stones. Treatment was performed either with the Dornier HM3 kidney lithotriptor (49 patients) or with the MPL 9000 lithotriptor (five patients).

Results: Stone disintegration was achieved in 50 patients (93 %), with complete stone clearance in 45 patients (83 %) (mean 1.2 sessions). Patients with successful stone removal after one session had significantly smaller stones than patients with treatment failure (20 ± 9 versus 27 ± 8 mm; p < 0.05). An intrahepatic location of stones was significantly associated with treatment failure (p < 0.005). Severe complications occurred in 7 % (procedure-related 5 %), with a 30-day mortality rate of 0 % (in-hospital mortality rate of 2 %). Minor side effects such as fever, petechiae, and mild arrhythmias were frequent (37 %), and microhematuria (94 %) occurred in nearly all of the patients. Symptomatic recurrent bile duct stones were observed in two patients (5 %) after three and four years, respectively (mean follow-up 5.3 years).

Conclusion: Extracorporeal shock wave lithotripsy represents a safe and effective treatment modality for difficult bile duct stones, with a low rate of symptomatic recurrences.