The successive shock wave pressure pulses result in direct shearing forces, as well as cavitation bubbles surrounding the stone, which fragment the stones into smaller pieces that then can easily pass through the ureters or the cystic duct.
22.
Generally this anomalous source is the superior mesenteric artery or more rarely the abdominal aorta, producing what has been described as a " replacing right hepatic artery ", passing through the hepatobiliary triangle and running posterior and parallel to the cystic duct.
23.
At the junction of the neck of the gallbladder and the cystic duct, there is an out-pouching of the gallbladder wall forming a mucosal fold known as "'Hartmann's pouch "', where gallstones commonly get stuck.
24.
Bile, required for the digestion of food, is secreted by the liver into passages that carry bile toward the hepatic duct, which joins with the cystic duct ( carrying bile to and from the gallbladder ) to form the common bile duct, which opens into the intestine.
25.
Based on the Autopsy Report, the true cause of Dr . Sun's death was " an adenocarcinoma of the gallbladder with obstruction of the cystic duct; direct extension to liver and diaphragm; widespread metastasis to lungs, peritoneum, and small and large intestines . " In addition to his cancer, he had gallstones, which frequently can be associated with gallbladder cancer; moderate generalized atherosclerosis; pulmonary emphysema and edema; and healed tuberculosis of the lungs.