Use of an electrohydraulic lithotripter in the percutaneous treatment of biliary tract calculi. The preliminary clinical experience in 4 cases

The results are reported of percutaneous transhepatic treatment with an electrohydraulic lithotripter in 4 cases of bile duct lithiasis. An electric discharge, generated by a bipolar electrode, gives origin to high-amplitude and low-frequency shock waves in the fluid medium which cause the stone to fragment. Complete resolution of lithiasis was obtained in 2 patients with intrahepatic calculosis. In the other 2 cases of massive lithiasis of intra and extrahepatic bile ducts the treatment, however incomplete, proved to be useful, as the biliary flux was rehabilitated and clinical symptoms disappeared. No relevant immediate side-effects were observed, except for well-tolerated pain during the discharges, and transitory hemobilia which solved spontaneously. No complications were observed in this series of patients. Electrohydraulic lithotripsy proves thus to be useful for supporting standard interventional radiology techniques in very complex cases of intra- and extrahepatic bile duct stones.