title: Use of external shock-wave lithotripsy and adjuvant ursodiol for treatment of radiolucent gallstones. A national multicenter study.
abstract: 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.
authors.affiliation: University of Nebraska Medical Center/Bishop Clarkson Hospital, Omaha.
authors.forename: D
authors.initials: D
authors.lastname: Burnett
authors.forename: A
authors.initials: A
authors.lastname: Ertan
authors.forename: R
authors.initials: R
authors.lastname: Jones
authors.forename: J P
authors.initials: JP
authors.lastname: O'Leary
authors.forename: R
authors.initials: R
authors.lastname: Mackie
authors.forename: J E
authors.initials: JE
authors.lastname: Robinson
authors.forename: G
authors.initials: G
authors.lastname: Salen
authors.forename: L
authors.initials: L
authors.lastname: Stahlgren
authors.forename: D H
authors.initials: DH
authors.lastname: Van Thiel
authors.forename: L
authors.initials: L
authors.lastname: Vassy
mesh_terms: 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*
chemical_list: D003840:Deoxycholic Acid; D014580:Ursodeoxycholic Acid