Extracorporeal shock-wave lithotripsy: Initial experience

Recently, there has been a revolution in the treatment of choledocholithiasis. With the appearance of extracorporeal shock-wave lithotripsy (ESWL) for the treatment of gallstones, we are at the dawn of a new era in the treatment of one of the most prevalent diseases in the country. In the United States, there are approximately 25 million patients with cholelithiasis; that is over 10% of the general population. ² Cholelitho- tripsy is a noninvasive procedure that accomplishes all fragmentation of biliary stones via extracorporeal shock waves, and it is offered as an alternative to the established surgical mehod. ³-⁵. Lithotripsy first was used successfully for the fragmentation of biliary calculi by the Dornier Company (Munich, West Germany) in 1975. ¹ However, it was in 1986 that Sauerbruch and colleagues published the first positive results in humans using a modified renal lithotriptor (Dornier HM3). Two years later, they presented 175 cases, with excellent results in 174. ⁶ In our institution, we have used cholelithotripsy in seven patients with choledocholithiasis. Our initial experience with these patients is the basis for our study.