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[Biliary extracorporeal shock-wave lithotripsy].

C Jakobeit1, L Greiner

  • 1Medizinische Klinik A, Kliniken, Stadt Wuppertal.

Schweizerische Rundschau Fur Medizin Praxis = Revue Suisse De Medecine Praxis
|July 14, 1992
PubMed
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Extracorporeal shock wave lithotripsy (ESWL) offers excellent results for bile duct stones, reducing the need for surgery. For gallbladder stones, ESWL combined with bile acid litholysis is effective only in carefully selected patients.

Area of Science:

  • Gastroenterology
  • Endourology
  • Digestive Surgery

Background:

  • Bile duct stones pose significant clinical challenges.
  • Surgical intervention has been the traditional treatment for bile duct stones.
  • Gallbladder stones require effective and minimally invasive treatment options.

Purpose of the Study:

  • To evaluate the efficacy of Extracorporeal Shock Wave Lithotripsy (ESWL) for treating intra- and extrahepatic bile duct stones.
  • To assess the outcomes of ESWL in combination with bile acid litholysis for gallbladder stone management.
  • To determine the patient subset most likely to benefit from ESWL for gallbladder stones.

Main Methods:

  • Retrospective analysis of over 200 patients treated with ESWL for bile duct stones since 1985/86.

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  • Application of ESWL combined with bile acid litholysis for selected gallbladder stone patients.
  • Evaluation of treatment success based on stone clearance and patient outcomes.
  • Main Results:

    • ESWL demonstrated excellent success rates for bile duct stones, comparable to its efficacy in urinary stone disease.
    • ESWL for bile duct stones has largely replaced open surgery.
    • For gallbladder stones, ESWL combined with bile acid litholysis showed promise in a specific patient group (10-15%) characterized by good gallbladder contractility, limited stone volume, and sonolucent stones.

    Conclusions:

    • ESWL is a highly effective treatment for bile duct stones, offering a less invasive alternative to surgery.
    • ESWL combined with bile acid litholysis can be successful for gallbladder stones, but patient selection is critical for optimal outcomes.