title: [Therapy of choledocholithiasis using extracorporeal shock wave lithotripsy and adjuvant surgical endoscopy].
abstract: Extracorporeal shock wave lithotripsy of extra- and intrahepatic bile duct stones is indicated after failure of conventional operative endoscopic procedures including mechanical lithotripsy. An overview of the current literature (12 centers, 568 patients) indicates that this novel procedure has attracted international acceptance. It was applied in elderly patients (means = 65 years) with solitary (37.5%) or multiple (62.5%) concrements. Clearance of the bile ducts was achieved in 71.6% after 1.3 to 3.0 lithotripsy sessions (1900-4000 shocks) if additional endoscopic sphincterotomy was performed. Without sphincterotomy 61% of patients were treated successfully. The most frequent side effects were macrohematuria (6.9%), hemobilia (6.2%) cholangitis (4.5%) and pancreatitis (1.3%). A lethality of 0-3.6% (means = 0.6%) was reported. The current results demonstrate that therapy of extra- and intrahepatic bile duct stones with extracorporeal shock wave lithotripsy is effective, safe and provides high therapeutic comfort.
authors.affiliation: I. Medizinische Klinik und Poliklinik, Johannes Gutenberg Universität, Mainz.
authors.forename: M
authors.initials: M
authors.lastname: Staritz
authors.forename: A
authors.initials: A
authors.lastname: Grosse
authors.forename: R
authors.initials: R
authors.lastname: Alkier
authors.forename: B
authors.initials: B
authors.lastname: Krzoska
authors.forename: K H
authors.initials: KH
authors.lastname: Meyer zum Büschenfelde
mesh_terms: D000368:Aged; D002761:Cholangitis / Q000209:etiology; D042882:Gallstones / Q000601:surgery / Q000628:therapy*; D006417:Hematuria / Q000209:etiology; D006431:Hemobilia / Q000209:etiology; D006801:Humans; D008096:Lithotripsy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology; D016717:Sphincterotomy, Endoscopic
vernacular_title: Therapie der Choledocholithiasis durch extrakorporale Stosswellenlithotripsie und adjuvante operative Endoskopie.