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[Chemolitholysis of gallstones as ambulatory treatment by the established physician]
H F Kienzle1, S Staemmler-Kienzle
1Chirurgische Klinik Städt. Klinikum Karlsruhe.
Abstract:
General Surgeons and physicians for internal medicine were asked for their results of dissolution-therapy of gallstones. 405 physicians were asked, 283 (69.9%) answered; 33.6% of these had some experience with the dissolution therapy. Data from 100 patients could be gathered completely: from 72 women (mean age 48 years) and from 27 men (mean age 53 years). The age-distribution resembled those of surgical gallstone-patients. In 27 cases the dissolution was successful (mean duration of therapy 49.6 weeks), in 25 cases there was a partial success (mean duration of therapy 54.8 weeks), and in 48 cases the dissolution-therapy failed (mean duration of therapy 55.5 weeks). In 60 cases therapy was stopped, but only 25 of these patients underwent cholecystectomy. In summary there is some evidence, that many collegues are sceptical against dissolution of gallstones, that the preoperative diagnostic procedure is ineffective, that the results of dissolution therapy in a common praxis is not as effective as in controlled studies, that dissolution therapy mainly is forced in patients at a normal risk--and not in high-risk patients, that only few patients are ready to take the pills longer than 1 year, and that in the case of stopping the therapy not all patients undergo consequently cholecystectomy.