title: [Laparoscopic cholecystectomy of large gallbladder calculi].
abstract: Laparoscopic cholecystectomy is more laborious in patients with large gallbladder stones in that they can only be removed safely after an enlargement of one incision or intraoperative lithotripsy. Preoperative extracorporeal shock-wave lithotripsy (ESWL) might theoretically solve this problem and facilitate the extraction of the gallbladder. Ten patients with minimum one stone > 20 mm of diameter received ESWL treatment within 24 h before operation. Complete pulverization of stones was achieved in only one patient. Additional mechanical fragmentation by forceps was necessary in 7 and an enlargement of the incision in 5 of 10 patients. Compared to 10 patients with corresponding stones and mechanical lithotripsy ESWL showed no advantage and cannot be recommended because of increase of costs.
authors.affiliation: Chirurgische Klinik und Poliklinik, Ludwig-Maximilians-Universität München.
authors.forename: V
authors.initials: V
authors.lastname: Lange
authors.forename: G
authors.initials: G
authors.lastname: Meyer
authors.forename: M
authors.initials: M
authors.lastname: Neubrand
authors.forename: U
authors.initials: U
authors.lastname: Klüppelberg
authors.forename: F W
authors.initials: FW
authors.lastname: Schildberg
mesh_terms: D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies
vernacular_title: Die laparoskopische Cholecystektomie bei grossen Gallenblasensteinen.