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Published on: September 13, 2022
Laparoscopic cholecystectomy after unsuccessful shock-wave therapy
1Department of Surgery, University of Freiburg, Germany.
Surgical Laparoscopy & Endoscopy
|September 1, 1992
Summary
Extracorporeal shock-wave therapy for gallstones is most effective for solitary stones under 20mm. Laparoscopic surgery is an alternative for those with unsuccessful lithotripsy or persistent symptoms.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
Background:
- Gallstone management has evolved with minimally invasive techniques.
- Extracorporeal shock-wave lithotripsy (ESWL) was explored as a non-invasive option.
Purpose of the Study:
- To evaluate the efficacy and outcomes of ESWL for gallstone treatment.
- To compare stone-free rates based on gallstone characteristics.
- To assess the role of ESWL in relation to surgical interventions.
Main Methods:
- Retrospective analysis of 85 patients treated with ESWL and dissolution therapy between 1988 and 1991.
- Categorization of patients based on stone number and size.
- Follow-up assessment of stone-free rates and complications.
Main Results:
- Higher stone-free rates (83%) observed in patients with solitary stones <20mm compared to multiple stones (49%) after 18 months.
- Seven patients required open cholecystectomy due to complications.
- Eight patients opted for laparoscopic cholecystectomy due to persistent biliary symptoms after a mean of 19 months of dissolution therapy.
Conclusions:
- ESWL is most effective for solitary cholesterol gallstones <20mm.
- Laparoscopic cholecystectomy serves as an alternative for patients with failed ESWL or ongoing symptoms.
- ESWL indication is limited to specific patient groups who decline surgery.
