Extracorporeal shockwave lithotripsy ESWL was introduced in as the preferred tool by the urologist for the treatment of renal stones and or upper ureteral stones. Urolithiasis is not the only application for extracorporeal shock waves but there are also other applications for it. Extracorporeal shock wave is used for the treatment of gall bladder stones, common bile duct stone clearance, pancreatic calculi, salivary stones, erectile dysfunction, and refractory angina pectoris chronic wound healing. Shock waves are single high amplitude sound waves produced by electrohydraulic, piezoelectric or electromagnetic methods that are transmitted into tissues with sudden rise from low pressure to its highest pressure at wave front followed by lower tensile amplitude [ 1 ]. The shock waves are condensed at a zone of highest energy concentration in the targeted area within the treated tissues.
There are different operative procedures, endoscopic procedures and lithotripsy methods available to treat gallbladder cancer and gallbladder inflammation or gallbladder stones. They include gallbladder removal choleocystectomy and gallbladder cystoscopy endoscopic retrograde cholangiopancreatography. Gallstones are the main reasons for surgical procedures on the gallbladder. Constrictions or blockages in the bile duct caused by tumours are further, rarer reasons for a surgery on bile ducts or the gallbladder.
Recently extracorporeal shockwave lithotripsy ESWL has been introduced as a nonoperative treatment for gallstone disease. Except for lung damage, no significant adverse effects of ESWL of gallbladder stones have been observed in animals. To achieve complete stone clearance, ESWL of gallbladder stones must be supplemented by an adjuvant therapy. ESWL of bile duct stones is highly effective and can be considered in patients in whom primary endoscopic or surgical stone removal fails. Second generation lithotriptors allow anesthesia-free outpatient treatments, but the clinical experience with most of these ESWL devices is still limited.
Gallstones that form in the gallbladder are the most common cause for blocked bile ducts. Additionally, bile duct stones can develop anywhere in the biliary tract where there is bile: within the liver, gallbladder and common bile duct. Gallstones and bile duct stones are usually comprised of cholesterol or bile salts — common components of bile — that have hardened into a stone. These stones can cause sudden pain when the cystic duct in the gallbladder or the common bile duct leading from the liver is blocked. Virginia Mason gastroenterologists treat this common problem in both adults and children with minimally invasive endoscopic technology.