Extracorporeal biliary lithotripsy is a technique which can allow some patients with gallstones to avoid open surgery. Its effectiveness depends on careful patient selection prior to the procedure. The need for this has been modified by development of modern laparoscopic techniques.



(1) history of at least one recent episode of typical biliary colic

(2) cholelithiasis confirmed by ultrasound

(3) functional gallbladder as shown by oral cholecystography

(4) shock wave path axis avoiding the lungs

(5) informed consent


Stone criteria:

(1) 1-3 stones that are non-opaque as shown by radiography (some allow up to 10 stones)

(2) maximum stone diameter 35 mm if 1 stone, 30 mm if 2 stones, 25 mm if 3 stones present

(3) minimum diameter for largest stone is 7 mm



(1) presence of known liver disease

(2) presence of acute or chronic cholecystitis

(3) presence of known and untreated choledocholithiasis

(4) past or present episodes of pancreatitis

(5) presence of bleeding tendencies

(6) presence of anticoagulant therapy

(7) cardiac pacemaker

(8) abnormal atrioventricular conduction

(9) pregnancy

(10) pneumonic consolidation


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