[Biliary shock-wave lithotripsy. Fragmentation and lysis--a new procedure]

Between September 1986 and April 1987, extracorporeal shock-wave lithotripsy, supplemented by oral chemolitholysis, was undertaken on 157 patients with symptoms of gallstones. Partial or complete stone fragmentation was achieved in 148 (94.3%). Freedom from stones was maintained under continuous chemolysis treatment for an average observation period of 8.5 weeks in 31 (19.7%). Considerable fragment reduction was obtained in 97 (61.8%), of whom 26 (16.6%) were demonstrated to have only minimal stone residues. Insufficient fragmentation and (or) no response to litholysis occurred in 29 (18.5%). These preliminary results suggest that, if there are moderately sized (less than 25 mm) and only a few (1-3) noncalcified cholesterol stones, these two methods in combination promise to be an effective alternative to cholecystectomy.