This Article Full Text (PDF) Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Malone, D. E. Articles by Burhenne, H. J. Search for Related Content PubMed PubMed Citation Articles by Malone, D. E. Articles by Burhenne, H. J.

Soft-tissue effects of biliary extracorporeal Shockwave lithotripsy in swine

Dermot E. Malone, MRCPI, FFRRCSI, FRCR Christoph D. Becker, MD ^* K. David Reich, MD Noel F. Quenville, MD, FRCPC and H. Joachim Burhenne, MD, FRCPC

Department of Radiology, University of British Columbia and Vancouver General Hospital, 855 West 12th Avenue, Vancouver, British Columbia, Canada V5Z1M9 Division of Anatomic Pathology, University of British Columbia and Vancouver General Hospital, 855 West 12th Avenue, Vancouver, British Columbia, Canada V5Z1M9

Correspondence: Author for correspondence.

This study investigates the soft-tissue effects of biliary extracorporeal Shockwave lithotripsy (BESWL) using a recently developed lithotripter, which consists of an electromagnetic Shockwave generator and an integrated ultrasonic targeting system. Sixteen swine, evenly divided into four groups, underwent BESWL. One group had one BESWL session targeted on the gallbladder and another group had two BESWL sessions targeted on the gallbladder. The third group had one BESWL session targeted on implanted gallbladder stones and the fourth group had one BESWL session targeted on the region of the common bile duct (CBD). Half of each group were sacrificed on the day of lithotripsy and half 1 week later. Post-mortem examinations were performed. Each implanted gallstone had fragmented. There were no findings attributable to BESWL in 11 animals. Three animals had pulmonary haemorrhagic spots (the largest was 10 mm in diameter) and one had a submucosal CBD petechia; these findings were attributable to BESWL. In two animals, microscopic haemorrhage associated with bronchopneumonia (usually present in our pig population) was more prominent than usual. This was possibly attributable to BESWL. The swine's deep posterior costophrenic sulcus makes it difficult to avoid the lung base during BESWL in swine. We conclude that this BESWL device can fragment gallstones without causing clinically significant soft-tissue damage.

^* Present address: Department of Diagnostic Radiology, University of Bern, Inselspital, 3010 Bern, Switzerland.

Received for publication January 1, 1989. Revision received May 1, 1989.