Densely calcified gallstone treated successfully with piezoelectric lithotripsy.

A patient with biliary pain and a densely calcified gallbladder stone was treated successfully with piezoelectric extracorporeal shock-wave lithotripsy. The gallstone was fragmented to particles of less than 1-2 mm in diameter in a single 1-h session. The procedure was performed in the outpatient setting and required no anesthesia or analgesia. Follow-up sonograms showed that clearance of residual fragments from the gallbladder had occurred within 1 wk. Our encouraging treatment result suggests the need for future research to be directed towards broadening the currently recommended criteria for biliary lithotripsy, which currently exclude treatment of densely calcified gallstones.