BILIARY EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY - THE EFFICACY AND SAFETY OF CONCOMITANT CATHETER CHOLECYSTOSTOMY DURING BILIARY LITHOTRIPSY

The major limitations of biliary extracorporeal shock wave lithotripsy (ESWL) relate to adequate stone fragmentation and clearance of the st one fragments. We hypothesized the removal of small fragments with con comitant catheter cholecystostomy during ESWL would improve its effica cy. ESWL with aspiration or flushing through three different cholecyst ostomy catheters was performed on pigs with surgically implanted galls tones. Twenty-two percent and 46% of the pre-ESWL stone weight were as pirated through the 10 and 12 French catheters respectively. The clear ance, size, and visualization of fragments was not significantly diffe rent between any of the groups. No significant post-mortem tissue or c atheter damage was found. Catheter aspiration is a safe and effective method of removing gallstone fragments during biliary ESWL, but it doc s not improve stone fragmentation, stone clearance, or visualization o f other fragments.