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Extracorporeal shock wave lithotripsy for bile duct stones using a piezoelectric lithotriptor: the Scottish lithotriptor centre experience.

There is less published data on the use of piezoelectric lithotripsy in the management of bile duct stones than on electrohydraulic or electromagnetic lithotripsy. We report our experience in treating 20 patients with large bile duct stones (median size 20 mm; range 15-30 mm) which could not be extracted endoscopically. Stone fragmentation was achieved in 75% of the patients and the bile duct was cleared in 65% of the patients. There were no procedure related complications and no 30-day mortality. None of the patients required any sedation or analgesia and all the sessions were well-tolerated. We conclude that piezoelectric lithotripsy is a safe and moderately effective option for difficult bile duct stones. It has the advantage that it is well-tolerated without the need for sedation or analgesia.