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Biliary lithotripsy: early observations in 106 patients. Work in progress.
H J Burhenne1, C D Becker, D E Malone
1Department of Radiology, University of British Columbia, Vancouver, Canada.
Radiology
|May 1, 1989
Summary
Extracorporeal shock wave lithotripsy effectively fragments gallstones and bile duct stones. While generally safe, potential complications include hemobilia and pancreatitis, necessitating careful patient selection and monitoring.
Area of Science:
- Gastroenterology
- Urology
- Endourology
Background:
- Cholelithiasis (gallstones) and bile duct stones are common conditions.
- Extracorporeal shock wave lithotripsy (ESWL) is a non-invasive treatment option.
Purpose of the Study:
- To evaluate the efficacy and safety of ESWL for cholelithiasis and bile duct stones.
- To assess ESWL as definitive therapy for symptomatic cholecystolithiasis.
Main Methods:
- 106 patients underwent ESWL for gallstones or bile duct stones.
- 28 patients received cholangiographically guided ESWL for bile duct stones.
- 78 outpatients with symptomatic cholecystolithiasis underwent ESWL guided by cholecystography or ultrasound (US).
Main Results:
- Bile duct stone fragmentation occurred in 71% of cases (20/28) with an average of two sessions.
- Hemobilia was observed in 14% of patients (4/28).
- US-guided ESWL for gallstones showed fragmentation in 86% of cases, with 46% having fragments ≤4 mm after 1.6 sessions.
- Complications included acute pancreatitis (2 patients) and acute cholecystitis (1 patient).
Conclusions:
- ESWL is an effective treatment for gallstones and bile duct stones.
- US-guided ESWL can be a definitive therapy for symptomatic cholecystolithiasis.
- Potential complications require consideration during treatment planning.