Results of a multicenter trial using a mechanical lithotripter for the treatment of large bile duct stones.

A prospective, uncontrolled trial of the use of a prototype mechanical lithotripter was performed in 116 patients at nine centers. Standard endoscopic approaches had failed to remove all stones, primarily because of large size (80% of patients). For 92% of patients, common bile duct stones were successfully captured and fragmented following the use of this lithotripter. The frequency of pancreatitis and hemorrhage was no greater than with standard endoscopic retrograde sphincterotomy, and complications unique to lithotripter use were not noted. For endoscopists skilled in therapeutic duodenoscopy, this modality should be considered in management of common bile duct stones refractory to standard techniques.