Korean J Gastrointest Endosc.  1998 Dec;18(6):863-871.

Endoscopic Treatment with ESWL of Impacted Cystic Duct Stones

• Moon JH
• Cho YD
• Park GH
• Hong SJ
• Song DH
• Kim YS
• Lee MS
• Shim CS

Abstract

BACKGROUND/AIMS
The established treatment for cystic duct stones is surgery, but nonoperative removal of gallstones through percutaneous cholecystostomy can also be a useful procedure in patients at high risk for surgery. Conventional methods using endoscopic or percutaneous stone extraction usually fail due to the inability to access or capture the cystic duct stones in the narrow, long, spiral portion of the cystic duct, especially in impacted cases. As a result stone fragmentation is required during endoscopic stone removal. It is impossible for an electrohydraulic lithotripsy (EHL) to gain access to the stones, due to the rigid distal metal tip of the lithotripter and the narrowness of the long, spiral cystic duct. Using extracorporeal shockwave lithotripsy (ESWL) to disintegrate gallstones is a more effective method for removal of cystic duct stones. Experiences of endoscopic treatment for cystic duct stones of patients with high risk for surgery were reviewed, and conclusions are included in this study.
METHODS
Patient records of endoscopic management of cystic duct stones between January, 1994 and December, 1997, were reviewed for methods and results of treatment. Most of the patients had undergone lithotripsy followed by percutaneous transhepatic cholecystostomy.

Keyword

Cystic duct stone; Endoscopic treatment; ESWL; Cholecystoscopy

MeSH Terms

Cholecystostomy
Cystic Duct*
Gallstones
Humans
Lithotripsy