Experimental percutaneous gallstone lithotripsy: results in swine.

The Kensey-Nash device is used to fragment gallstones percutaneously. It is inserted into the gallbladder through an 8-F introducer sheath, a cage is expanded to protect the gallbladder, and the impeller is activated. A strong vortex automatically pulls the stones into the basket. The device was tested in 24 pigs in which human gallstones (5-19 mm, bilirubin and cholesterol types) had been implanted and in two control pigs with no gallstones. All pigs except two were killed immediately after the procedure (acute studies); the two were followed up for 36 days and then killed. Fragments (1-3 mm) were similar in size to those seen in current extracorporeal shock wave lithotripsy studies. A complication occurred in one animal, and technical failures occurred in two, causing these three studies to be aborted.