What is lithotripsy for gallstones?

Lithotripsy is a nonsurgical procedure to crush stones inside your gallbladder. A lithotripsy machine focuses sound waves against the gallstones to break them into smaller pieces that can pass out of your gallbladder through the bile ducts into the small intestine.

The gallbladder is shaped like a balloon and holds bile. Bile is produced by the liver and helps with digestion of fats in the intestinal tract. Bile can create a sediment that forms gallstones. These stones can remain loose in your gallbladder or block the gallbladder or get stuck in the common bile duct. Or they may enter the intestine and be passed out of your body in a bowel movement.

If the stones clog the gallbladder neck, the flow of bile will be partially blocked. A gallbladder blocked by a stone can become painful, swollen, infected, or scarred. Gallstones can cause inflammation of the pancreas and liver, causing jaundice. They can cause life-threatening problems.

When is it used?

Lithotripsy is another way besides surgery to try to remove gallstones. It may be tried if you are not well enough to have surgery.

Lithotripsy may not succeed in removing gallstones. Alternatives to this procedure include:

• using drugs to dissolve the stones

• having a catheter (a small tube) put directly into your gallbladder to inject fluids to dissolve the stones

• having the gallbladder removed surgically

• having the gallbladder removed by laparoscopy

• choosing not to have treatment while recognizing the risks of your condition.

You should ask your doctor about these choices.

You should not have lithotripsy if you are pregnant, have a pacemaker, or have serious problems with your heartbeat.

How do I prepare for lithotripsy?

Follow your doctor's instructions. If you are to have a general anesthetic, eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

No special preparation is needed for local anesthesia.

What happens during the procedure?

You will probably have a local instead of a general anesthetic. A local anesthetic is a drug that should keep you from feeling pain during the operation.

You will lie on a table above the lithotripsy machine. It will send focused sound waves against the gallstones, breaking them. The doctor will use an ultrasound machine to find the gallstones, keep the sound waves focused on them, and track their breakdown. The stones can then pass down the common bile duct into the intestine or dissolve.

What happens after the procedure?

You may be in the recovery room for a few hours until you have recovered from the anesthetic. Then you can go home. You should have someone drive you home. You should take the drug your doctor prescribes regularly for 3 to 15 months after this procedure, depending on your condition. The drug will help dissolve pieces of stone left in the gallbladder. It is very important to follow your doctor's instructions and take the drug as recommended.

Ask your doctor what other steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

Lithotripsy is a way to try to remove gallstones without surgery.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your doctor.

• A local anesthesia may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. Local anesthesia is considered safer than general anesthesia.

• You may have the same pain as before this treatment as the pieces of stone pass out of your gallbladder.

• Some of the crushed gallstone could irritate your gallbladder or bile ducts.

• If your bile duct becomes blocked, your pancreas could become inflamed, causing abdominal pain and nausea.

• In the future more gallstones may form in your gallbladder.

You should ask your doctor how these risks apply to you.

When should I call the doctor?

Call the doctor immediately if you are in a lot of pain.

Call the doctor during office hours if:

• You have questions about the procedure or its result.

• You want to make another appointment.