Use of external shock-wave lithotripsy and adjuvant ursodiol for treatment of radiolucent gallstones. A national multicenter study.
A prospective multicenter trial was performed to evaluate the use of external shockwave lithotripsy (ESL) and adjuvant medical therapy for the treatment of gallstones. A Medstone STS lithotripter was used together with ursodiol. Two hundred twenty-three patients were treated under general anesthesia (75%) or with intravenous analgesia (25%). Initial treatments were on an inpatient basis, but as centers gained experience, outpatient treatments became more common. Stone fragmentation and clearance were greatest in patients with solitary gallstones less than 2 cm in diameter. In this group of patients, stone fragmentation occurred in 97% of patients, and the cumulative stone-free rates at three and six months were 54% and 90%, respectively. These results indicate that fragmentation of gallstones can be achieved by a dry shock-wave lithotripter and that stone clearance is induced more rapidly by external shock-wave lithotripsy and adjuvant ursodiol therapy than by ursodiol therapy alone.
Burnett
D
D
University of Nebraska Medical Center/Bishop Clarkson Hospital, Omaha.
Ertan
A
A
Jones
R
R
O'Leary
J P
JP
Mackie
R
R
Robinson
J E
JE
Salen
G
G
Stahlgren
L
L
Van Thiel
D H
DH
Vassy
L
L
D000328:Adult; D000368:Aged; D002769:Cholelithiasis / Q000000981:diagnostic imaging / Q000628:therapy*; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003840:Deoxycholic Acid / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D011446:Prospective Studies; D011859:Radiography; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use*
D003840:Deoxycholic Acid; D014580:Ursodeoxycholic Acid