Radiology, Vol 177, 719-721, Copyright © 1990 by Radiological Society of North America
Extracorporeal cholecystolithotripsy without oral chemolitholysis
JS Fache, B Rawat and HJ Burhenne
Department of Radiology, University of British Columbia, Vancouver, Canada.
One hundred thirty-six patients completed extracorporeal biliary
lithotripsy (EBL) for symptomatic cholecystolithiasis. Sonographic evidence
of complete clearance of all stone fragments was the only criterion for
treatment success, which occurred in 32 of the 71 patients (45%) followed
up for 24 weeks and in 36 of the 59 patients (61%) followed up for 52
weeks. The authors' protocol varied from protocols of other researchers
primarily in that no adjuvant chemolitholysis was used. However, the number
of treatment sessions and total number of shock waves (a maximum of 4,000
shock waves per treatment session, 12,000 shock waves in a patient
demonstrating no significant fragmentation, and 20,000 shock waves in a
patient whose stones responded well to fragmentation) was higher than those
in other reports. The results of treatment and complication rates in this
study are comparable with those at centers using both shock-wave
lithotripsy and chemotherapy. The authors conclude that EBL is developing
into an important alternative to surgery, which was obviated in all
patients with complete clearance of fragments from the gallbladder.
