Percutaneous endoscopic cholecystolithotripsy. Work in progress.
In spite of long-term adjunctive oral dissolution therapy, residual gallstones have been reported in up to 50% of gallstone patients 3 months after extracorporeal shock-wave lithotripsy. Six women and five men, aged 31-75 years, underwent percutaneous endoscopic cholecystolithotripsy between April 1988 and October 1988. The gallbladder was punctured by means of an anterior transperitoneal approach. The tract was dilated, and gallstones were removed with a modified 21-F cholecystoscope under direct visual inspection. Calculi too large for extraction were disintegrated with ultrasound or electrohydraulic lithotripsy. Eight patients were stone-free and two had small residual stones 3 months later; nine were stone-free 6 months after the procedure. Although more invasive than shock-wave lithotripsy, percutaneous endoscopic cholecystolithotripsy has the advantage of immediate removal of more calculi, causes less pain, necessitates less postoperative immobilization, and allows patients to leave the hospital sooner.
Hruby
W
W
Department of Radiology, Zentralrontgeninstitut X-Ray Department, Vienna, Austria.
Stackl
W
W
Urban
M
M
Armbruster
C
C
Marberger
M
M
D000328:Adult; D000368:Aged; D002758:Cholangiography; D002769:Cholelithiasis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008096:Lithotripsy / Q000379:methods; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography