We encountered significant liver fibrosis in a healthy young patient undergoing laparoscopic cholecystectomy for symptomatic gallstone disease. Twelve months prior to cholecystectomy the patient underwent multiple extracorporeal shock-wave lithotripsy (ESWL) sessions with adjuvant oral bile-acid therapy. Since the site of fibrosis corresponded clearly to the shock-wave transmission path, which was in accordance with animal studies, it was concluded that this liver fibrosis was a side effect of biliary ESWL. Based on these findings and the literature, we conclude that further assessment of the long-term safety of ESWL is still warranted, especially in patients undergoing multiple ESWL sessions.

Complications, ESWL, Fibrosis, Gallstones, Lithotripsy, Liver, Side effects
dx.doi.org/10.1007/BF00188295, hdl.handle.net/1765/60575
Surgical Endoscopy: surgical and interventional techniques
Erasmus MC: University Medical Center Rotterdam

Plaisier, P.W, Hamming, J.F, van der Hul, R.L, den Toom, R, & Bruining, H.A. (1994). Liver fibrosis after extracorporeal shock-wave lithotripsy of gallbladder stones - A case report. Surgical Endoscopy: surgical and interventional techniques, 8(11), 1335–1337. doi:10.1007/BF00188295