Early gallstone recurrence rate after successful shock-wave therapy

Area of Science:

• Gastroenterology
• Hepatobiliary Surgery
• Endourology

Background:

• Extracorporeal shock-wave lithotripsy (ESWL) combined with bile-acid dissolution therapy effectively clears radiolucent gallbladder stones.
• Patients with intact gallbladders remain at risk for gallstone recurrence after successful treatment.

Purpose of the Study:

• To evaluate the early rate of gallstone recurrence after successful ESWL and adjuvant bile-acid dissolution therapy.
• To assess the incidence of recurrent biliary pain associated with gallstone recurrence.

Main Methods:

• Follow-up examinations were conducted on 58 of the first 60 stone-free patients at least 1 year after therapy cessation.
• Recurrence was assessed through patient-reported symptoms and imaging studies.
• Actuarial analysis was used to estimate recurrence rates up to 3 years.

Main Results:

• Nine percent of patients experienced gallstone recurrence within the first year.
• Recurrent gallstones were detected in 5 patients who reported biliary pain.
• Actuarial analysis estimated an 11% probability of recurrence by 1.5 years, with no significant increase up to 3 years.

Conclusions:

• Gallstone recurrence within one year after ESWL is expected in approximately 9% of patients.
• Recurrence often leads to recurrent biliary pain, similar to rates observed in post-dissolution trials.
• Long-term monitoring is crucial for patients treated with ESWL for gallbladder stones.