Atlas of Gastroenterological Endoscopy
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Extracorporal shock wave lithotrypsy (ESWL)
Big as well as small stones can be fragmented by ESWL before extraction. The example shows a 7 mm calculus in the left hepatic bile duct adhering tightly to the ductular wall. Neither an extraction device nor a guide wire could pass the concrement.
Move the mouse´s arrow onto the figure to outline the stone.
Extracorporal shock wave lithotripsy achieved a fragmentation of the stone. The fragments show as filling defects behind the target crosslines. Lavage with physiologic saline washes the debris out of the hepatic duct.