Extracorporeal lithotripsy of intrahepatic stones with associated strictures of intrahepatic biliary ducts

Background and Aims, Intrahepatic stones are a frequent disease in the East ern world but rare in Western countries. Treatment is complex and often req uires surgical intervention. Extracorporeal shock wave lithotripsy is a rel atively recent technique, widely used in the treatment of stones in the gal lbladder and common bile duct. It can also be used in the treatment of intr ahepatic stones. The present study analyses the efficacy of extracorporeal shock wave lithotripsy in intrahepatic stones. Patients and Methods. In our study, we used extracorporeal lithotripsy in s ix cases of intrahepatic stones (mean age 53 years). In five of these cases deformities of the intrahepatic bile ducts were also present: stenoses and angulated strictures. The stones were in the right lobe of the liver in 5 patients, and in both lobes in 1 patient. Four patients had multiple stones and 2 a single stone, all varying in diameter from 6 ro 25 mm. The stones were localized radiologically with contrast medium through a drainage tube. The technique does not require anaesthesia. An average of three lithotrips y sessions were necessary, with a mean total of 8050 shock waves per patien t. Results. Successful fragmentation was obtained in 5 out of 6 patients, whil e the remaining subsequently underwent surgery. No complications were obser ved. Conclusions. Extracorporeal shock wave lithotripsy proved to be effective, easy to perform and safe for the treatment of intrahepatic stones.