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Results of extracorporeal shock-wave lithotripsy of gall-bladder stones in 693 patients: a plea for restriction to solitary radiolucent stones

André Elewaut, A Crape, Marcel Afschrift, W Pauwels, Martine De Vos UGent and Fabrice Barbier (1993) GUT. 34(2). p.274-278
abstract
During a period of 24 months 693 consecutive patients with symptomatic gall bladder stones (526 males, 167 females; mean age 51 years, range 18-89) were treated by extracorporeal shock wave lithotripsy with a Piezolith 2300. The procedure was carried out on an outpatient basis without analgesics or sedatives. Concomitant chemolitholytic treatment (ursodeoxycholic and chenodeoxycholic acid 7-5 mg/kg/day each) was administered until three months after total fragment clearance for a maximum therapy period of 1.5 years. In 601 patients with radiolucent stones complete clearance of all fragments was obtained after three, six, 12, and 18 months in respectively 20, 41, 64, and 78%. Actuarial analysis of the subgroups according to the stone mass (size and number) selected an ideal patient population with solitary stones less than 20 mm diameter (84% stone free after one year). The results are significantly less good when the greater the number of stones or their maximal diameter increases. Treatment was interrupted in 3.6% of the patients. In 90 sludge or fragments remain present. Twenty five patients were lost to follow up for non-biliary reasons. Stone recurrence was 5.7% at one year and was observed both in patients with solitary and multiple stones. A cost effectiveness analysis suggests that laparoscopic cholecystectomy is the most effective and economic solution, although extracorporeal shock wave lithotripsy for solitary radiolucent stones less than 2 cm is cheaper than conventional cholecystectomy. Extracorporeal shock wave lithotripsy for multiple stones is the most expensive and least effective option.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
GALLSTONE RECURRENCE, PIEZOELECTRIC LITHOTRIPSY, GALLBLADDER STONES, FOLLOW-UP, BILIARY LITHOTRIPSY, DISSOLUTION, ACID, CHOLECYSTECTOMY, FRAGMENTATION, URSODIOL
journal title
GUT
Gut
volume
34
issue
2
pages
274 - 278
Web of Science type
Article
ISSN
0017-5749
DOI
10.1136/gut.34.2.274
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
200946
handle
http://hdl.handle.net/1854/LU-200946
date created
2004-01-14 13:42:00
date last changed
2016-12-19 15:38:50
@article{200946,
  abstract     = {During a period of 24 months 693 consecutive patients with symptomatic gall bladder stones (526 males, 167 females; mean age 51 years, range 18-89) were treated by extracorporeal shock wave lithotripsy with a Piezolith 2300. The procedure was carried out on an outpatient basis without analgesics or sedatives. Concomitant chemolitholytic treatment (ursodeoxycholic and chenodeoxycholic acid 7-5 mg/kg/day each) was administered until three months after total fragment clearance for a maximum therapy period of 1.5 years. In 601 patients with radiolucent stones complete clearance of all fragments was obtained after three, six, 12, and 18 months in respectively 20, 41, 64, and 78\%. Actuarial analysis of the subgroups according to the stone mass (size and number) selected an ideal patient population with solitary stones less than 20 mm diameter (84\% stone free after one year). The results are significantly less good when the greater the number of stones or their maximal diameter increases. Treatment was interrupted in 3.6\% of the patients. In 90 sludge or fragments remain present. Twenty five patients were lost to follow up for non-biliary reasons. Stone recurrence was 5.7\% at one year and was observed both in patients with solitary and multiple stones. A cost effectiveness analysis suggests that laparoscopic cholecystectomy is the most effective and economic solution, although extracorporeal shock wave lithotripsy for solitary radiolucent stones less than 2 cm is cheaper than conventional cholecystectomy. Extracorporeal shock wave lithotripsy for multiple stones is the most expensive and least effective option.},
  author       = {Elewaut, Andr{\'e} and Crape, A and Afschrift, Marcel and Pauwels, W and De Vos, Martine and Barbier, Fabrice},
  issn         = {0017-5749},
  journal      = {GUT},
  keyword      = {GALLSTONE RECURRENCE,PIEZOELECTRIC LITHOTRIPSY,GALLBLADDER STONES,FOLLOW-UP,BILIARY LITHOTRIPSY,DISSOLUTION,ACID,CHOLECYSTECTOMY,FRAGMENTATION,URSODIOL},
  language     = {eng},
  number       = {2},
  pages        = {274--278},
  title        = {Results of extracorporeal shock-wave lithotripsy of gall-bladder stones in 693 patients: a plea for restriction to solitary radiolucent stones},
  url          = {http://dx.doi.org/10.1136/gut.34.2.274},
  volume       = {34},
  year         = {1993},
}

Chicago
Elewaut, André, A Crape, Marcel Afschrift, W Pauwels, Martine De Vos, and Fabrice Barbier. 1993. “Results of Extracorporeal Shock-wave Lithotripsy of Gall-bladder Stones in 693 Patients: a Plea for Restriction to Solitary Radiolucent Stones.” GUT 34 (2): 274–278.
APA
Elewaut, A., Crape, A., Afschrift, M., Pauwels, W., De Vos, M., & Barbier, F. (1993). Results of extracorporeal shock-wave lithotripsy of gall-bladder stones in 693 patients: a plea for restriction to solitary radiolucent stones. GUT, 34(2), 274–278.
Vancouver
1.
Elewaut A, Crape A, Afschrift M, Pauwels W, De Vos M, Barbier F. Results of extracorporeal shock-wave lithotripsy of gall-bladder stones in 693 patients: a plea for restriction to solitary radiolucent stones. GUT. 1993;34(2):274–8.
MLA
Elewaut, André, A Crape, Marcel Afschrift, et al. “Results of Extracorporeal Shock-wave Lithotripsy of Gall-bladder Stones in 693 Patients: a Plea for Restriction to Solitary Radiolucent Stones.” GUT 34.2 (1993): 274–278. Print.