[Extracorporeal biliary lithotripsy: results in 60 cases of single calculus]

The outcome of 60 cases of single biliary stone with a maximum diameter of 25 mm was evaluated. The patients were symptomatic, with functioning gallbladder, and were selected from a group of 180 to evaluate the effects of electrohydraulically generated shockwaves on a priori ideal cases for this procedure. In seven patients fragmentation was not achieved, probably because of the pigmentary character of the stone, that was later verified at cholecystectomy. In 20 out of the 53 in whom fragmentation was satisfactory (38%), fragments were not observed after 24 hours. 32 patients (54%) had a stone-free gallbladder 3 months afterwards; at six months, the number had increased to 40 (66%). This rate becomes 77% if only the cases with fragmentation are considered. In 29% of patients episodes of colicky biliary pain developed as complication. No case of pancreatitis or stuck in gallstone were observed. We conclude that shock waves appear as an excellent therapeutic alternative in single gallstones up to 25 mm in size.