Extracorporeal shock-wave lithotripsy of gallbladder stones
Su, C.H.; Huang, S.M.; Lui, W.Y.
Journal of the Formosan Medical Association 91(9): 902-906
1992
ISSN/ISBN: 0929-6646 PMID: 1363392 Document Number: 403142
Recently, extracorporeal shock-wave lithotripsy has been introduced as a nonoperative treatment for gallstone disease. To evaluate its applicability in Taiwan, where cholesterol stones are not very frequent, 18 patients out of 194 (9.3%) were selected according to the Munich inclusion criteria to receive this treatment. Chenodeoxycholic acid and ursodeoxycholic acid were administered as adjunctive litholytic therapy. Twenty-eight sessions of lithotripsy were performed, resulting in a 83% satisfactory fragmentation rate (< or = 5 mm). No serious complications were encountered; however, two patients later underwent laparoscopic cholecystectomy. The stones disappeared in four patients after treatment, but recurred in one after discontinuation of oral bile acids. The long-term result was discouraging compared to European reports. A 13% stone-free rate was noticed at one year and 25% was anticipated during the 13-18 month follow-up. It is our conclusion that low eligibility, low cost-effectiveness and poor treatment results will restrict the wide-spread use of this nonoperative therapy in Taiwan.