title: [Extracorporeal lithotripsy in gallbladder lithiasis].
abstract: Extracorporeal shock-wave lithotripsy (ESWL) has been used since 1986 as an alternative to surgery for the treatment of uncomplicated gallstone disease, as it induces fragmentation of gallstones. The major determinant of fragmentation is the total stone volume. Lithotripsy must be associated with oral bile acid therapy to obtain a complete disappearance of the fragments. The methodological aspects, the criteria for inclusion and exclusion and the results of ESWL are discussed. The preliminary results seem to be satisfactory with regard to stone fragmentation and to safety. However, in order to determine exactly the place of ESWL in the treatment of gallstones, some questions must be answered: which are the best lithotripters, what are the best indications of ESWL, what is the rate of stone recurrence after successful therapy, what kind of monitoring is needed after the stones have disappeared? While this new therapeutic approach is being evaluated, ESWL must be applied only to symptomatic gallstones.
authors.affiliation: Service des Maladies du foie et de l'appareil digestif, Hôpital de Bicêtre, Le Kremlin-Bicêtre.
authors.forename: G
authors.initials: G
authors.lastname: Pelletier
authors.forename: J P
authors.initials: JP
authors.lastname: Etienne
mesh_terms: D001647:Bile Acids and Salts / Q000627:therapeutic use; D002769:Cholelithiasis / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006801:Humans; D008096:Lithotripsy / Q000009:adverse effects
chemical_list: D001647:Bile Acids and Salts
vernacular_title: Lithotritie extracorporelle de la lithiase vésiculaire.