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Extracorporeal shock wave lithotripsy of gallstones revisited: Current status and future promises
Author(s) -
Mulagha Eneya,
Fromm Hans
Publication year - 2000
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1046/j.1440-1746.2000.02094.x
Subject(s) - medicine , gallstones , lithotripsy , extracorporeal shock wave lithotripsy , shock wave lithotripsy , bladder stones , population , surgery , urology , general surgery , urinary system , environmental health
The improvement and refinement of extracorporeal shock wave lithotripsy (ESWL) has made this non‐invasive treatment modality not only more effective, but also applicable to a larger population of gallstone patients. It can be performed safely on an outpatient basis. Advances in lithotripsy technology have made it possible to fragment stones into very small, sand‐like particles (pulverization), which clear the gall‐bladder faster than large fragments. Recent studies provide evidence that adjuvant bile acids may not be necessary in most cases in which pulverization is achieved. Good gall‐bladder emptying appears both to promote the clearance of gallstones after ESWL and to decrease their recurrence. Although generally found to be more expensive than surgery if bile acids are used, ESWL should be cost‐effective, as bile acids may not be necessary in all patients. Elderly patients with radiolucent, solitary and less than 30 mm gallstones can particularly benefit from lithotripsy. © 2000 Blackwell Science Asia Pty Ltd