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Gallbladder stones: shockwave therapy.

¹Department of Medicine II, Klinikum Grosshadern, University of Munich, Germany.

Bailliere'S Clinical Gastroenterology

|November 1, 1992

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Extracorporeal shockwave lithotripsy is a safe and effective non-invasive treatment for select gallstone patients. This therapy offers a favorable outcome with low recurrence rates, making it an attractive option for suitable candidates.

Area of Science:

Gastroenterology
Urology
Medical Technology

Background:

Gallstone disease affects a significant portion of the population.
Surgical interventions like cholecystectomy carry inherent risks.
Non-invasive therapies are sought for gallstone management.

Purpose of the Study:

To evaluate the safety and efficacy of extracorporeal shockwave lithotripsy (ESWL) for gallstone disease.
To identify ideal patient candidates for ESWL.
To compare ESWL with existing gallstone treatment modalities.

Main Methods:

ESWL utilizes shockwaves to fragment gallstones.
Patient selection based on stone characteristics (single, radiolucent, size ≤ 20-25 mm) and gallbladder function.
Adjuvant bile acid dissolution therapy may be used.

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Outcomes assessed by fragment clearance, recurrence rates, and cost-effectiveness.

Main Results:

ESWL is proven safe and effective for selected patients.
Approximately 20% of gallstone patients are suitable candidates.
Fragment evacuation depends on stone factors, fragmentation success, and gallbladder contractility.
Complete fragment disappearance typically occurs over several months.

Conclusions:

ESWL is an attractive non-invasive therapeutic option for carefully selected patients with gallstones.
It offers an alternative to general anesthesia and invasive procedures.
Cost-effectiveness is comparable to open cholecystectomy, with favorable outcomes and low recurrence for ideal candidates.