Clearance of irretrievable bile duct and pancreatic duct stones by extracorporeal shockwave lithotripsy, using a transportable device: Effectiveness and medium-term results

Rita Conigliaro, Lorenzo Camellini, Claudia G. Zuliani, Romano Sassatelli, Maria G. Mortilla, Giorgio Bertoni, Debora Formisano, Giuliano Bedogni

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

BACKGROUND AND GOALS: Extracorporeal shockwave lithotripsy (ESWL) is an established treatment of irretrievable biliary and pancreatic stones, but the cost of the shockwave generators limits its widespread use. We revised data about the effectiveness of our treatment for refractory stones using a transportable shockwave generator. STUDY: We retrospectively evaluated the short and medium-term outcomes of patients who underwent ESWL using a transportable electromagnetic shockwave generator between 1998 and 2003 at our unit, for the treatment of irretrievable bile duct or pancreatic duct stones. All patients received intravenous conscious sedation and antibiotic prophylaxis. RESULTS: Complete stone clearance was achieved in 70/82 patients (85.4%), in 66 of the patients (94.2%) with 1 session of ESWL. Despite the insertion of a stent in the bile duct, 2 patients had moderate cholangitis, while they waited for the next ESWL session. We did not record any moderate-severe complication of ESWL, but 2 patients underwent surgery owing to perforation/bleeding during endoscopic removal of residual fragments. A symptomatic recurrence of stones was recorded in 10/69 (14.5%) patients, who had been previously cleared and whose follow-up data (median follow-up 29 mo; range 7 to 66) were available. CONCLUSIONS: We obtained satisfactory stone clearance by using a transportable shockwave generator. Most patients required 1 session. Our experience confirmed the safety of the treatment, even though patients may experience cholangitis while awaiting definitive treatment. The use of a transportable ESWL generator may be a valuable option in centers, while ensuring a sufficient proficiency in biliary endoscopy.

Original languageEnglish
Pages (from-to)213-219
Number of pages7
JournalJournal of Clinical Gastroenterology
Volume40
Issue number3
DOIs
Publication statusPublished - Mar 2006

Fingerprint

Lithotripsy
Pancreatic Ducts
Bile Ducts
Equipment and Supplies
Cholangitis
Conscious Sedation
Antibiotic Prophylaxis
Electromagnetic Phenomena
Therapeutics
Endoscopy
Stents
Hemorrhage
Safety
Costs and Cost Analysis
Recurrence

Keywords

  • Choledocholitiasis
  • Endoscopy
  • Extracorporeal shockwave lithotripsy
  • Gastrointestinal
  • Pancreatitis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Clearance of irretrievable bile duct and pancreatic duct stones by extracorporeal shockwave lithotripsy, using a transportable device : Effectiveness and medium-term results. / Conigliaro, Rita; Camellini, Lorenzo; Zuliani, Claudia G.; Sassatelli, Romano; Mortilla, Maria G.; Bertoni, Giorgio; Formisano, Debora; Bedogni, Giuliano.

In: Journal of Clinical Gastroenterology, Vol. 40, No. 3, 03.2006, p. 213-219.

Research output: Contribution to journalArticle

Conigliaro, Rita ; Camellini, Lorenzo ; Zuliani, Claudia G. ; Sassatelli, Romano ; Mortilla, Maria G. ; Bertoni, Giorgio ; Formisano, Debora ; Bedogni, Giuliano. / Clearance of irretrievable bile duct and pancreatic duct stones by extracorporeal shockwave lithotripsy, using a transportable device : Effectiveness and medium-term results. In: Journal of Clinical Gastroenterology. 2006 ; Vol. 40, No. 3. pp. 213-219.
@article{625ca5f1513d4d0e9cc47057bcefb8ed,
title = "Clearance of irretrievable bile duct and pancreatic duct stones by extracorporeal shockwave lithotripsy, using a transportable device: Effectiveness and medium-term results",
abstract = "BACKGROUND AND GOALS: Extracorporeal shockwave lithotripsy (ESWL) is an established treatment of irretrievable biliary and pancreatic stones, but the cost of the shockwave generators limits its widespread use. We revised data about the effectiveness of our treatment for refractory stones using a transportable shockwave generator. STUDY: We retrospectively evaluated the short and medium-term outcomes of patients who underwent ESWL using a transportable electromagnetic shockwave generator between 1998 and 2003 at our unit, for the treatment of irretrievable bile duct or pancreatic duct stones. All patients received intravenous conscious sedation and antibiotic prophylaxis. RESULTS: Complete stone clearance was achieved in 70/82 patients (85.4{\%}), in 66 of the patients (94.2{\%}) with 1 session of ESWL. Despite the insertion of a stent in the bile duct, 2 patients had moderate cholangitis, while they waited for the next ESWL session. We did not record any moderate-severe complication of ESWL, but 2 patients underwent surgery owing to perforation/bleeding during endoscopic removal of residual fragments. A symptomatic recurrence of stones was recorded in 10/69 (14.5{\%}) patients, who had been previously cleared and whose follow-up data (median follow-up 29 mo; range 7 to 66) were available. CONCLUSIONS: We obtained satisfactory stone clearance by using a transportable shockwave generator. Most patients required 1 session. Our experience confirmed the safety of the treatment, even though patients may experience cholangitis while awaiting definitive treatment. The use of a transportable ESWL generator may be a valuable option in centers, while ensuring a sufficient proficiency in biliary endoscopy.",
keywords = "Choledocholitiasis, Endoscopy, Extracorporeal shockwave lithotripsy, Gastrointestinal, Pancreatitis",
author = "Rita Conigliaro and Lorenzo Camellini and Zuliani, {Claudia G.} and Romano Sassatelli and Mortilla, {Maria G.} and Giorgio Bertoni and Debora Formisano and Giuliano Bedogni",
year = "2006",
month = "3",
doi = "10.1097/00004836-200603000-00008",
language = "English",
volume = "40",
pages = "213--219",
journal = "Journal of Clinical Gastroenterology",
issn = "0192-0790",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Clearance of irretrievable bile duct and pancreatic duct stones by extracorporeal shockwave lithotripsy, using a transportable device

T2 - Effectiveness and medium-term results

AU - Conigliaro, Rita

AU - Camellini, Lorenzo

AU - Zuliani, Claudia G.

AU - Sassatelli, Romano

AU - Mortilla, Maria G.

AU - Bertoni, Giorgio

AU - Formisano, Debora

AU - Bedogni, Giuliano

PY - 2006/3

Y1 - 2006/3

N2 - BACKGROUND AND GOALS: Extracorporeal shockwave lithotripsy (ESWL) is an established treatment of irretrievable biliary and pancreatic stones, but the cost of the shockwave generators limits its widespread use. We revised data about the effectiveness of our treatment for refractory stones using a transportable shockwave generator. STUDY: We retrospectively evaluated the short and medium-term outcomes of patients who underwent ESWL using a transportable electromagnetic shockwave generator between 1998 and 2003 at our unit, for the treatment of irretrievable bile duct or pancreatic duct stones. All patients received intravenous conscious sedation and antibiotic prophylaxis. RESULTS: Complete stone clearance was achieved in 70/82 patients (85.4%), in 66 of the patients (94.2%) with 1 session of ESWL. Despite the insertion of a stent in the bile duct, 2 patients had moderate cholangitis, while they waited for the next ESWL session. We did not record any moderate-severe complication of ESWL, but 2 patients underwent surgery owing to perforation/bleeding during endoscopic removal of residual fragments. A symptomatic recurrence of stones was recorded in 10/69 (14.5%) patients, who had been previously cleared and whose follow-up data (median follow-up 29 mo; range 7 to 66) were available. CONCLUSIONS: We obtained satisfactory stone clearance by using a transportable shockwave generator. Most patients required 1 session. Our experience confirmed the safety of the treatment, even though patients may experience cholangitis while awaiting definitive treatment. The use of a transportable ESWL generator may be a valuable option in centers, while ensuring a sufficient proficiency in biliary endoscopy.

AB - BACKGROUND AND GOALS: Extracorporeal shockwave lithotripsy (ESWL) is an established treatment of irretrievable biliary and pancreatic stones, but the cost of the shockwave generators limits its widespread use. We revised data about the effectiveness of our treatment for refractory stones using a transportable shockwave generator. STUDY: We retrospectively evaluated the short and medium-term outcomes of patients who underwent ESWL using a transportable electromagnetic shockwave generator between 1998 and 2003 at our unit, for the treatment of irretrievable bile duct or pancreatic duct stones. All patients received intravenous conscious sedation and antibiotic prophylaxis. RESULTS: Complete stone clearance was achieved in 70/82 patients (85.4%), in 66 of the patients (94.2%) with 1 session of ESWL. Despite the insertion of a stent in the bile duct, 2 patients had moderate cholangitis, while they waited for the next ESWL session. We did not record any moderate-severe complication of ESWL, but 2 patients underwent surgery owing to perforation/bleeding during endoscopic removal of residual fragments. A symptomatic recurrence of stones was recorded in 10/69 (14.5%) patients, who had been previously cleared and whose follow-up data (median follow-up 29 mo; range 7 to 66) were available. CONCLUSIONS: We obtained satisfactory stone clearance by using a transportable shockwave generator. Most patients required 1 session. Our experience confirmed the safety of the treatment, even though patients may experience cholangitis while awaiting definitive treatment. The use of a transportable ESWL generator may be a valuable option in centers, while ensuring a sufficient proficiency in biliary endoscopy.

KW - Choledocholitiasis

KW - Endoscopy

KW - Extracorporeal shockwave lithotripsy

KW - Gastrointestinal

KW - Pancreatitis

UR - http://www.scopus.com/inward/record.url?scp=33748141090&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33748141090&partnerID=8YFLogxK

U2 - 10.1097/00004836-200603000-00008

DO - 10.1097/00004836-200603000-00008

M3 - Article

C2 - 16633122

AN - SCOPUS:33748141090

VL - 40

SP - 213

EP - 219

JO - Journal of Clinical Gastroenterology

JF - Journal of Clinical Gastroenterology

SN - 0192-0790

IS - 3

ER -