Radiology, Vol 178, 781-785, Copyright © 1991 by Radiological Society of North America
Percutaneous rotational contact biliary lithotripsy: initial clinical results with the Kensey Nash lithotrite
FJ Miller, SC Rose, KN Buchi, JG Hunter, JE Nash and KR Kensey
Department of Radiology, University of Utah Medical Center, Salt Lake City 84132.
The percutaneous rotary lithotrite introduces a new concept to
fragmentation and percutaneous removal of gallstones. A fluid vortex is
generated, pulling calculi into a high-speed blade that fragments stones to
predominantly under 500 microns. The results of treating the first 10
patients with this instrument reveal that large stone burdens as well as
small stones (2-3 mm) of any composition can be removed if the gallbladder
is of sufficient size to accommodate the six-pronged basket. Rotation times
of 7-39 minutes were required. Nine of 10 procedures were completed; access
was lost in one case. One major complication occurred. At repeat oral
cholecystography, the gallbladder was visualized after 3-6 weeks in eight
of the nine patients. Ursodeoxycholic acid was administered from 3 to 12
months to five patients with either residual stones or aggregates. The
hospital stay ranged from 48 to 72 hours. All patients (except the patient
who underwent surgery) resumed light activity in 3-4 days and strenuous
activity and full diet within 3 weeks.
