Extracorporeal shock-wave lithotripsy of gallbladder stones.
Recently, extracorporeal shock-wave lithotripsy has been introduced as a nonoperative treatment for gallstone disease. To evaluate its applicability in Taiwan, where cholesterol stones are not very frequent, 18 patients out of 194 (9.3%) were selected according to the Munich inclusion criteria to receive this treatment. Chenodeoxycholic acid and ursodeoxycholic acid were administered as adjunctive litholytic therapy. Twenty-eight sessions of lithotripsy were performed, resulting in a 83% satisfactory fragmentation rate (< or = 5 mm). No serious complications were encountered; however, two patients later underwent laparoscopic cholecystectomy. The stones disappeared in four patients after treatment, but recurred in one after discontinuation of oral bile acids. The long-term result was discouraging compared to European reports. A 13% stone-free rate was noticed at one year and 25% was anticipated during the 13-18 month follow-up. It is our conclusion that low eligibility, low cost-effectiveness and poor treatment results will restrict the wide-spread use of this nonoperative therapy in Taiwan.
Department of Surgery, Veterans General Hospital, National Yang-Ming Medical College, Taipei, Taiwan, R.O.C.
C H
CH
Su
S M
SM
Huang
W Y
WY
Lui
D000328:Adult; D000368:Aged; D002635:Chenodeoxycholic Acid / Q000627:therapeutic use; D002763:Cholecystectomy; D002769:Cholelithiasis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008096:Lithotripsy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
D002635:Chenodeoxycholic Acid; D014580:Ursodeoxycholic Acid