[Is extracorporeal lithotripsy in appendicular lithiasis an alternative to cholecystectomy?]

This study was done with the EDAP LT 01 piezoelectric lithotripter. Experimental fragmentation of biliary stones was evaluated in vitro and in vivo after implantation of human stones inside the gallbladder of pigs. Tissue damage was appreciated after application of ESWL to the gallbladder of pigs with firing frequencies from 40 to 1.25 shots per second. 125 patients were treated in our centre since 1987. Duration of the session was about one hour, without any anaesthesia or analgesia. The patients are no more hospitalised. An other session was necessary in case of unsatisfactory fragmentation. All the patients were treated by adjuvant dissolving agents. The results are in course of evaluation. Fragmentation of gallstones is obtained in 80 to 99% of the patients. Side effects are rarely observed and there was no case of acute pancreatitis in this series. With the Dornier machine, a complete stone clearance was obtained in 80% of the patients after one year and 93% after two years but there was a 10% rate of gallstones recurrence after one year of clearance. Place of ESWL for gallstones in the future needs to be carefully assessed.