title: [Extracorporeal shockwave lithotripsy of the gallbladder: importance of selection criteria].
abstract: In recent years, a number of alternatives to surgery for gallstones have been developed. Among them, extracorporeal shock-wave lithotripsy (ESWL) was promising, being non-invasive and risk-free. Nevertheless, its results vary according to the size, number and composition of the stones and according to the bile acids treatment used for fragment dissolution. To better evaluate the importance of these factors, we have widened the selection criteria currently used (1 to 3 non-calcified stones with a diameter below 30 mm) by including patients with large stones (up to 40 mm in diameter), multiple stones (up to 10 stones) and calcified stones. We also compared, for efficacy of fragment dissolution after ESWL, treatment by ursodeoxycholic acid alone as opposed to a mixture with chenodeoxycholic acid. Our results were (1) significant lessening of the fragmentation rate and of the number of gallbladders free of stones 1 year after ESWL when selection criteria are widened; (2) a mixture of ursodeoxycholic and chenodeoxycholic acids may favour fragment dissolution after ESWL compared to treatment by ursodeoxycholic acid alone.
authors: Division de gastroentérologie CHUV/PMU, Lausanne.
authors: J
authors: J
authors: Thorens
authors: J F
authors: JF
authors: Schnegg
authors: J
authors: J
authors: Fasel
authors: C
authors: C
authors: Deslarzes
authors: B
authors: B
authors: Duvoisin
authors: P
authors: P
authors: Schnyder
authors: J J
authors: JJ
authors: Gonvers
authors: A L
authors: AL
authors: Blum
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002635:Chenodeoxycholic Acid / Q000008:administration & dosage; D002769:Cholelithiasis / Q000188:drug therapy / Q000628:therapy*; D000075202:Contraindications; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008096:Lithotripsy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014580:Ursodeoxycholic Acid / Q000008:administration & dosage
chemical_list: D002635:Chenodeoxycholic Acid; D014580:Ursodeoxycholic Acid
vernacular_title: Lithotritie vésiculaire par ondes de choc extracorporelles: importance des critères de sélection.