Case Report
Biliary Lithotripsy in the United States
Abstract
THE FIRST CHOLECYSTECTOMY was done by Langenbuch in Berlin more than 100 years ago. Since that time it has become a safe and effective method of treating cholelithiasis; nevertheless, it is a major operation, and in recent years non-operative alternatives have been sought. The use of orally administered bile acids for the dissolution of gallstones is slow, expensive, and usually ineffective. Percutaneous or endoscopic retrograde instillation of solvents in the biliary tract appears to be successful in dissolving gallstones, but it requires invasive intubation of the biliary tract and has been associated with significant complication rates.Extracorporeal shock wave lithotripsy was first used to break up renal calculi in humans in 1980 in Munich.5,6 In 1983, Brendel and Enders7 used lithotripsy to fragment human gallstones implanted in the gallbladders of dogs. In 1986, Sauerbruch et al,8 from Germany, reported extracorporeal shock wave therapy for gallstones in nine patients. Brown et al9 recently used lithotripsy in conjunction with endoscopic manipulation of hepatic and common bile duct stones in two patients in the United States.This content is limited to qualifying members.
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