EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY FOR TREATMENT OF INTRAHEPATIC STONES - INVITRO AND INVIVO STUDIES

In vitro, bile duct stones, mostly comprising calcium bilirubinate, ar e readily fragmented by extracorporeal shockwave lithotripsy (ESWL). I n the case of intrahepatic stones, ESWL is effective if the stones flo at freely in the bile, but if the stones completely fill, or are impac ted within, the hepatic duct or bile duct, attempts at fragmentation w ill end in failure. Three patients with intrahepatic stones were treat ed with ESWL, and effectively fragmented. The stone fragments passed o ut spontaneously through T-tube sinus tract, PTDC sinus tract and the sphincter of Oddi as shown in the second cholangiogram. No specific co mplication was noted in our experimental and clinical experience. We b elieve that ESWL for fragmentation of biliary stones is technically re liable. The problem of the passage of these fragmented stones is consi dered; if necessary, it can be overcome by endoscopic means.