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Related Experiment Videos

How many Americans will be eligible for biliary lithotripsy?

T H Magnuson1, K D Lillemoe, H A Pitt

  • 1Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, Md.

Archives of Surgery (Chicago, Ill. : 1960)
|October 1, 1989
PubMed
Summary

Extracorporeal shock wave lithotripsy (ESWL) is a potential alternative to cholecystectomy. This study found only 19% of patients undergoing cholecystectomy were eligible for ESWL, suggesting limited current applicability.

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Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery

Background:

  • Cholecystectomy is a common surgical procedure for gallstones.
  • Extracorporeal shock wave lithotripsy (ESWL) is emerging as a non-invasive alternative.
  • Data on patient eligibility for ESWL after cholecystectomy is limited.

Purpose of the Study:

  • To determine the percentage of patients undergoing cholecystectomy who meet current eligibility criteria for ESWL.
  • To assess the potential impact of ESWL as an alternative treatment for gallstones in the United States.

Main Methods:

  • Prospective study of 100 consecutive adult patients undergoing cholecystectomy.
  • Review of preoperative history and operative findings.
  • Assessment of gallstone characteristics (size, number, composition, radiopacity) against ESWL exclusion criteria.

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Main Results:

  • Gallstones were present in 95% of patients (74% cholesterol, 21% pigment).
  • Only 19% of the 100 patients met the eligibility criteria for ESWL.
  • An estimated 95,000 Americans annually could be candidates for ESWL.

Conclusions:

  • Current eligibility criteria significantly limit the application of ESWL as an alternative to cholecystectomy.
  • Further research may be needed to refine ESWL candidacy criteria for gallstone disease.
  • ESWL shows potential for a subset of patients with gallstones, but widespread adoption requires further evaluation.