Radiology, Vol 178, 105-108, Copyright © 1991 by Radiological Society of North America
Retained intrahepatic stones: treatment with piezoelectric lithotripsy combined with stone extraction
BI Choi, JK Han, YH Park, YB Yoon, MC Han and CW Kim
Department of Radiology, Seoul National University College of Medicine, Korea.
Extracorporeal shock wave lithotripsy (ESWL) was performed in 11 patients
with oriental cholangiohepatitis and intrahepatic stones associated with
segmented strictures of intrahepatic ducts. All patients had previously
undergone biliary surgery and basket extraction via a T-tube tract at the
time of lithotripsy. The indication for ESWL was failure of, or anticipated
difficulty with, basket extraction of the stones via a T-tube tract. A
piezoelectric lithotriptor was used in all procedures. The average total
number of shock waves administered was 29,756 (range, 10,000-61,395). The
average number of treatment sessions was 3.1 (range, 1-6); the number of
shock waves used in a single session ranged from 10,000 to 15,000 with a
frequency of five shots per second and 30%-50% power. In six patients, the
stones were successfully fragmented and completely removed; in three of the
others of the stones were fragmented and removed. The overall success rate,
including complete (54%) and incomplete (27%) success, was 82%. Difficulty
in targeting stones, and severe strictures and deformities of intrahepatic
ducts, were the factors responsible for failure. No significant
complications were observed.
