EXTRACORPOREAL PIEZOELECTRIC LITHOTRIPSY OF INTRAHEPATIC AND EXTRAHEPATIC BILIARY-TRACT STONES

64 patients (27 men, 37 women; mean age 71 27-90! years) with intra- or extrahepatic biliary stones, which could not be extracted endoscopi cally, underwent extracorporeal piezoelectric shock-wave lithotripsy ( ESWL). The piezoelectric lithotriptor which was used localizes the sto nes sonographically and the shock-waves are produced by a self-focusin g sound generator consisting of 3,000 ceramic elements. The sonographi c localization of the stones was successful in 57 patients (89%) and c omplete removal of stones was achieved in 49 (77%), after an average o f 7,595 (1,000-30,800) shock-waves per patient. Spontaneous eliminatio n of stone fragments occurred in 7 patients, while in 42 further endos copic procedures (balloon catheter, Dormia basket, mechanical lithotri psy) were needed to remove stone fragments from the biliary tract. The only severe complication was cholangitis in two cases. It probably re sulted from the associated lysis treatment. There was no case of pancr eatitis and no death at 30 days. - These data indicate that piezoelect ric ESWL with sonographic stone localization is an effective method wi th few side effects for treating problematic biliary tract stones.