[Oral and direct lysis of gallbladder calculi. Competing or complementary procedures to shockwave lithotripsy?].
Non-surgical treatment of cholesterol gallstones is possible with oral chemolitholysis employing chenodeoxycholic acid (CDA) and/or ursodeoxycholic acid (UDA), oral chemolitholysis following ESWL and direct dissolution with methyl tert-butyl ether (MTBE). Oral chemolitholysis takes a long time (6-24 months), is suitable only for small stones (up to 1.5 cm) and has a success rate of 60-70%. Prior ESWL shortens the duration of oral treatment moderately and can be employed with larger (up to 3 cm) stones; it is, however, quite expensive. The new method of direct chemolysis of gallstones is rapid, very cheap, and effective (approx. 95% success rate), but is an invasive procedure. If previous results obtained with MTBE are confirmed, it could become a therapeutic alternative to cholecystectomy in the case of very large and multiple stones.
Kurtz
W
W
Hellstern
A
A
Leuschner
U
U
D000284:Administration, Oral; D002635:Chenodeoxycholic Acid / Q000008:administration & dosage*; D002769:Cholelithiasis / Q000628:therapy*; D003131:Combined Modality Therapy; D003840:Deoxycholic Acid / Q000031:analogs & derivatives*; D006801:Humans; D008096:Lithotripsy; D014580:Ursodeoxycholic Acid / Q000008:administration & dosage*
D003840:Deoxycholic Acid; D002635:Chenodeoxycholic Acid; D014580:Ursodeoxycholic Acid
Orale und direkte Lyse von Gallenblasensteinen. Konkurrierende oder ergänzende Verfahren zur Stosswellenlithotripsie (ESWL)?