Mechanical lithotripsy is used to break large bile duct stones.
In this study, researchers from India investigated the predictors of unsuccessful mechanical lithotripsy.
The team evaluated 669 consecutive patients with bile duct stones who underwent endoscopic retrograde cholangiography, sphincterotomy, and basket removal of stones.
Mechanical lithotripsy was performed for stones that were greater than 15mm in diameter.
|Impaction of the stone in the bile duct was the only factor that predicted failure.|
The team defined a complete clearance of the duct as a success.
They considered several factors, including size and number of stones, stone impaction, serum bilirubin, presence of cholangitis, and bile duct diameter in relation to the success or failure of lithotripsy.
The team found that of the 669 patients, 401 had choledocholithiasis. Of these, 87 had large stones that required mechanical lithotripsy.
Lithotripsy was successful in 79% of the patients.
The investigators determined that impaction of the stone(s) in the bile duct was the only factor that predicted failure of lithotripsy and the consequent failure of bile duct clearance.
Dr Pramod Kumar Garg's team concluded, "Mechanical lithotripsy is successful in about 79% of patients with large bile duct stones".
"The only significant factor that predicts failure of mechanical lithotripsy is stone impaction in the bile duct".