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[Extracorporeal shockwave biliary lithotripsy. Physical basis and clinical application]
N Méndez-Sánchez1, M Uribe-Esquivel, F Bosques
1Clínica de Hígado del Instituto Nacional de la Nutrición Salvador Zubirán México, D.F.
Summary
Extracorporeal shock wave lithotripsy effectively fragments biliary stones using electromagnetic energy, achieving high success rates without anesthesia. This minimally invasive treatment offers a safe and efficient option for gallstone management.
Area of Science:
- Medical physics
- Gastroenterology
- Urology
Context:
- Extracorporeal shock wave lithotripsy (ESWL) is a modern medical procedure for treating urinary and biliary stones.
- Shock waves, akin to sonic waves, obey acoustic laws and can be focused within the body due to its high water content.
Purpose:
- To evaluate the efficacy and safety of electromagnetic extracorporeal biliary lithotripsy (ECL) for treating gallstones.
- To assess the fragmentation rate and complication profile of ECL.
Summary:
- A study treated 78 patients with biliary stones using an electromagnetic shock wave generator (Lithostar plus) without analgesia or anesthesia.
- Total stone fragmentation was achieved in 85% of cases. Cholesterol gallstones required adjuvant oral cholesterol solvent therapy.
- Extracorporeal biliary lithotripsy demonstrated zero mortality and less than 5% morbidity.
Impact:
- ECL offers a safe, non-invasive alternative for gallstone treatment with high fragmentation success.
- The procedure's low morbidity rate makes it a viable option for selected patients.
- Further research can optimize ECL protocols and expand its application in biliary stone management.