Technical Review of Lithotripsy Devices for Percutaneous Management of Biliary Stones: A Guide for Interventional Radiologists

Abstract This review provides a comprehensive overview of intracorporeal lithotripsy techniques, focusing on laser and electrohydraulic lithotripsy, for the management of biliary tract stones. Biliary stones pose a significant health concern, affecting a notable percentage of the adult population, with potentially life-threatening complications. Minimally invasive approaches, such as lithotripsy, offer advantages over traditional, open surgical methods, including reduced risk of complications, shorter hospital stays, and faster recovery times. Laser lithotripsy employs light emission and amplification to fragment stones, while electrohydraulic lithotripsy generates shockwaves from a bipolar probe tip for fragmentation. Solid-state lasers like holmium and thulium fiber lasers are considered the gold standard, with recent advancements enhancing their efficiency and safety profiles. Safety precautions and patient preparation are essential for successful outcomes. Future directions for platform utilization may focus on optimizing parameters, exploring new therapeutic indications, and refining fiber designs. Overall, intracorporeal lithotripsy techniques represent valuable options for biliary stone management, improving patient care and quality of life through a minimally invasive approach.