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Digestive Disease Interventions
DOI: 10.1055/s-0044-1801819
Review Article

Technical Review of Lithotripsy Devices for Percutaneous Management of Biliary Stones: A Guide for Interventional Radiologists

Mohammad Mirza-Aghazadeh-Attari
1   Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland
,
Arun Kamireddy
1   Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland
,
Alec Jost
1   Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland
,
Hannatu Bwayili
1   Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland
,
Harjit Singh 
1   Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland
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Abstract

This review provides a comprehensive overview of intracorporeal lithotripsy techniques, focusing on laser and electrohydraulic lithotripsy, for the management of biliary tract stones. Biliary stones pose a significant health concern, affecting a notable percentage of the adult population, with potentially life-threatening complications. Minimally invasive approaches, such as lithotripsy, offer advantages over traditional, open surgical methods, including reduced risk of complications, shorter hospital stays, and faster recovery times. Laser lithotripsy employs light emission and amplification to fragment stones, while electrohydraulic lithotripsy generates shockwaves from a bipolar probe tip for fragmentation. Solid-state lasers like holmium and thulium fiber lasers are considered the gold standard, with recent advancements enhancing their efficiency and safety profiles. Safety precautions and patient preparation are essential for successful outcomes. Future directions for platform utilization may focus on optimizing parameters, exploring new therapeutic indications, and refining fiber designs. Overall, intracorporeal lithotripsy techniques represent valuable options for biliary stone management, improving patient care and quality of life through a minimally invasive approach.

Keywords

lithotripsy - laser - cholelithiasis - interventional radiology - biliary system

Declarations

H.S. is a consultant to Cook Medical and Inari. The other authors declare no conflicts of interest.


Ethical Considerations

Not applicable




Publication History

Received: 07 December 2024

Accepted: 17 December 2024

Article published online:
29 January 2025

© 2025. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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