PIEZOELECTRIC LITHOTRIPSY OF GALLBLADDER STONES - ACUTE AND LONG-TERM RESULTS

Extracorporeal piezoelectric lithotripsy [PEL] with oral lysis [about 7.5 mg/kg urso- and chenodeoxycholic acid as single dose in the evening] was performed, according to a standardized treatment and follow-up protocol, in 219 patients [177 women, 42 men; aged 47 +/- 14 years] with symptoms of gallbladder stones. The average number of treatment sessions per patient was 2.0 +/- 0.8. Significantly fewer sessions with fewer shockwave charges were required in solitary gallstones of less-than-or-equal-to 20 mm diameter than in those of > 20 mm diameter and in multiple concrements [P < 0.01]. Fragmentation was successful in 99% of patients. Sedation and/or analgesia during PEL were required in only 2 % of patients. There were no marked side effects during the treatment. The stone-free rate 12 months after the start of treatment was 76 % in the group with solitary stones less-than-or-equal-to 20 mm, 75% with solitary stones > 20 mm and 64% for multiple stones. During the follow-up period 36 % of patients had biliary colics and 3 % had fragments impacted in the common bile duct. Biliary pancreatitis occurred in 1 % of patients. PEL is an effective and sparing procedure in the treatment of selected patients with gallbladder stones.