Large Impacted Intrahepatic Bile Duct Stones: Usefulness of Ultrasonic Lithotripsy

ABSTRACT

PURPOSE: To determine the usefulness of ultrasonic lithotripsy for the fragmentation of large impacted intrahepatic duct(IHD) stones. MATERIALS AND METHODS: Large impacted stones in five patients were fragmented with a 12.5F rigid ureterorenoscope and a 5.5F rigid ultrasonic oscillating burr via T-tube tract. Two to three dayslater, the fragmented stones were extracted via T-tube tract with basket. RESULTS: Disintegration was complete in three patients and partial in two. The fragmented stones were completely removed in four patients and partially in one. due to that patient's refusal. CONCLUSION: Insertion of a rigid endoscope and ultrasound drill into theorifice of the IHD can be performed without problem. Ultrasonic lithotripsy is an effective technique for the fragmentation of large impacted intrahepatic stones located in the or ifice of the IHD.