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Biliary lithotripsy.

D Vanderpool1, R C Jones, J P O'Leary

  • 1Department of Surgery, Baylor University Medical Center, Dallas, Texas.

American Journal of Surgery
|September 1, 1989
PubMed
Summary
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Gallstone lithotripsy combined with ursodeoxycholic acid therapy effectively fragments gallstones, achieving a 50% clearance rate for solitary stones under 20 mm. This treatment is a safe and useful option for managing cholelithiasis.

Area of Science:

  • Gastroenterology
  • Medical Devices
  • Hepatology

Background:

  • Gallstone disease (cholelithiasis) affects a significant portion of the population.
  • Extracorporeal shock wave lithotripsy (ESWL) emerged as a non-invasive treatment option.
  • Bile acid therapy, such as ursodeoxycholic acid, has been explored to aid gallstone dissolution and prevent recurrence.

Purpose of the Study:

  • To evaluate the efficacy and safety of gallstone lithotripsy using the Medstone STS lithotripter.
  • To assess the impact of combining lithotripsy with ursodeoxycholic acid therapy.
  • To determine the success rates of fragmentation and clearance for gallstones.

Main Methods:

  • Prospective study involving 81 patients treated with Medstone STS lithotripsy for gallstones.

Related Experiment Videos

  • Randomized allocation for pre-treatment with ursodeoxycholic acid in half the patients.
  • Post-treatment follow-up for 4 months to assess clearance rates and adverse events.

    • Main Results:

    • Gallstone fragmentation achieved in 95% of all patients, and 97% for solitary stones < 20 mm.
    • A 50% clearance rate was observed for solitary stones < 20 mm.
    • Adverse effects were infrequent, including mild skin bruising (20%) and post-treatment biliary colic (33%).

    Conclusions:

    • Gallstone lithotripsy with the Medstone STS lithotripter is effective in fragmenting gallstones.
    • Combining lithotripsy with ursodeoxycholic acid therapy is a useful approach for managing cholelithiasis.
    • The treatment demonstrates a favorable safety profile with manageable side effects.