Related Experiment Videos
Cavitation effects during lithotripsy. Part II. Clinical observations
R K Zeman1, W J Davros, J A Goldberg
1Department of Radiology, Georgetown University Medical Center, Washington, DC 20007.
Radiology
|October 1, 1990
Summary
Microbubble formation during gallstone lithotripsy predicts fragmentation success. However, liver microbubbles indicate temporary liver damage, suggesting adjustments to lithotriptor placement to minimize hepatic cavitation effects.
Area of Science:
- Medical Imaging and Intervention
- Gastroenterology
- Acoustic Physics
Background:
- Biliary lithotripsy uses shock waves to break gallstones.
- Cavitation effects can generate microbubbles, visible sonographically.
- The clinical significance of these microbubbles requires further investigation.
Purpose of the Study:
- To investigate the relationship between microbubble formation and clinical outcomes in gallstone lithotripsy.
- To assess microbubble formation as a predictor of successful gallstone fragmentation.
- To determine the correlation between microbubble formation and hepatocellular damage.
Main Methods:
- Fifty gallstone lithotripsy treatments in 29 patients were analyzed.
- Sonography was used to visualize microbubble formation in bile and liver.
- Serum transaminase levels were monitored to assess hepatocellular damage.
Main Results:
- Microbubble formation in bile predicted successful stone fragmentation in 31 of 34 treatments.
- Microbubble formation in the liver correlated with transient hepatocellular damage in 7 of 10 treatments.
- Hepatocellular damage appeared as a twofold rise in serum transaminase levels.
Conclusions:
- Microbubble formation in bile is a useful predictor of gallstone fragmentation success.
- Liver microbubble formation is associated with temporary hepatocellular damage post-lithotripsy.
- Adjusting lithotriptor focal volume placement may reduce hepatic cavitation and associated damage.