[Gallstone treatment by electrohydraulic extracorporeal shockwave lithotripsy]

Abstract

Extracorporeal shockwave lithotripsy (ESWL) with an electrohydraulic system was performed in 124 patients (33 men, 91 women; mean age 50.1 +/- 12.7 years). Sufficient stone fragmentation was achieved in 122 patients (98.3%). ESWL was repeated in 29 patients (23.3%), twice in 7 patients (5.6%). Average shockwave application per patient was 1,441 +/- 414 impulses, at a mean energy of 20.0 +/- 1.6 kV. Mean stone diameter before ESWL was 16.2 +/- 4.2 (7-30) mm, 7.1 +/- 4.1 (0-19) mm after ESWL. Computed tomography, performed immediately after ESWL in 88 patients demonstrated hypodense thickening (3-10 mm) of the gallbladder wall in 28.4% of patients. This was interpreted as wall oedema, reversible in all. One patient had a covered gallbladder rupture and two had biliary pancreatitis. None of the patients required emergency surgery. 93 patients (74.9%) had no stones 12 months later. A high success rate can be achieved if certain criteria are adhered to and suitable patients are selected.