[Combination therapy of gallbladder stones using extracorporeal shock waves and bile acids: results in relation to stone diameter and stone number].
420 patients were referred to our center for gallstone lithotripsy. 97 patients (23%) with radiolucent gallbladder stones (total diameter less than or equal to 3 cm) and intact gallbladder function were found suitable for extracorporal shock-wave lithotripsy. Disintegration of gallbladder stones was achieved in 92 of the 97 patients (95%). Chenodeoxycholic acid and ursodeoxycholic acid were used as adjuvant litholytic therapy. The therapeutic results were evaluated cumulatively in 90 patients after a follow-up of 10 months. 80% of patients with solitary stones (less than or equal to 20 mm in diameter (n = 46) had a stone-free gallbladder, whereas patients with solitary stones greater than 2 cm, less than or equal to 3 cm in diameter (n = 20) and multiple stones (n = 22) became stone-free in only 28% (p less than 0.01). During the observation period 21 patients (23%) experienced biliary colics, 2 (2%) mild pancreatitis, 2 (2%) showed fragment impaction in the common bile duct, and 17 (19%) displayed transient microscopic hematuria. Our results confirm previous studies showing that solitary stones sized up to 2 cm in diameter represent the best suited subgroup for extracorporeal shock-wave lithotripsy.
Stölzel
U
U
Freie Universität Berlin, Klinikum Steglitz.
Lenz
K
K
Gregor
M
M
Arntz
R
R
Tung
L C
LC
Riecken
E O
EO
D000368:Aged; D002635:Chenodeoxycholic Acid / Q000627:therapeutic use*; D002769:Cholelithiasis / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D003085:Colic / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006417:Hematuria / Q000209:etiology; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use*
D002635:Chenodeoxycholic Acid; D014580:Ursodeoxycholic Acid
Kombinierte Therapie von Gallenblasensteinen mit extrakorporalen Stosswellen und Gallensäuren: Ergebnisse in Abhängigkeit von Steindurchmesser und Steinzahl.