EDAP piezoelectric shock wave lithotripsy for gallbladder stones.

EDAP piezoelectric shock wave lithotripsy combined with oral ursodeoxycolic acid dissolution of stones was used to treat 1055 patients with gallbladder stones. 926 of them (87.8%) were followed up for more than 1 year. The patients were divided into two groups: Group I, 637 patients with functioning gallbladders containing one radiolucent stone less than or equal to 20 mm in diameter or 2 to 3 stones each less than or equal to 12 mm, and Group II: 289 patients with stones exceeding the above criteria. The stone fragmentation rate was 96.2% and 94.1% respectively in Group I and in Group II. Gallbladder stones disappeared in 18.5%, 35.0%, 46.2% and 52.4% of the patients in Group I in 1, 3, 6, and 12 months after treatment and 7.3%, 11.4%, 20.1%, and 27.7% in Group II. The treatment was more effective for solitary stones less than or equal to 20 mm in diameter. No serious complications were noted. The midterm curative effect was satisfactory. Further study is required to raise the curative effect and prevent stone recurrence.

Extracorporeal shock wave lithotripsy. Experience in treating 245 patients with gallbladder stones.

An EDAP LT-01 lithotripter was used to treat 245 patients with functioning gallbladders containing one to three radiolucent stones of less than 20 mm in diameter. Ursodeoxycholic acid was administrated as adjuvant litholytic therapy. The gallbladder stones disintegrated in 98.8% of patients and disappeared completely in 21.2% within 1 month after lithotripsy, in 26.5% within 2 months, in 33.9, 40, 46.5, 48.6 and 53.9% within 3, 4, 6, 9, and 12 months, respectively. Adverse effects after lithotripsy were dull abdominal pain (49.4%), biliary colic (13.1%), jaundice (1.2%), and pancreatitis (0.4%). Extracorporeal shock wave lithotripsy combined with litholytic therapy is a non-invasive, painless, safe, and effective treatment in selected patients. Patients with solitary radiolucent stone less than 20 mm in diameter are considered candidates for extracorporeal shock wave lithotripsy (ESWL). The key to success of ESWL lies in the strict selection of patients, careful monitoring throughout the lithotriptic procedure, and enough litholytic therapy. The disadvantages of this method include strict selection of patients and high costs, poor curative effect, and recurrence of stones (11.4% of patients).