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Induced gall‐bladder contraction accelerates fragment clearance after extracorporeal shockwave lithotripsy
Author(s) -
ZIEGENHAGEN DIETER J.,
ZEHNTER ELMAR,
KRUIS WOLFGANG,
POHL CHRISTOPH
Publication year - 1993
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 - 10.1111/j.1440-1746.1993.tb01538.x
Subject(s) - medicine , ceruletide , lithotripsy , gallstones , gall , ursodeoxycholic acid , saline , urology , extracorporeal , surgery , contraction (grammar) , extracorporeal shockwave lithotripsy , gastroenterology , cholecystokinin , botany , receptor , biology
Abstract At the end of extracorporeal shockwave lithotripsy (ESWL) gallstone fragments are dispersed throughout the gall‐bladder. In this state they should be expelled more easily than when later sedimented to the gall‐bladder fundus. Thus, a randomized study was performed to evaluate the clinical benefit of induced gall‐bladder contraction after ESWL. One hundred and five patients with radiolucent gallstones (1–3 stones, diameter ≤ 30 mm) were randomized to received either saline or an infusion of 0.2 μg/kg ceruletide. Stone clearance rates and incidence of biliary symptoms were recorded. Clearance rates at 6 weeks and 3 months after ESWL were significantly ( P ≤ 0.025) improved by the ceruletide infusion. This effect, resulting in shortened bile acid therapy, was limited to patients with small solitary stones and dependent on a good initial fragmentation. Major side effects attributable to ceruletide were not observed. These results suggest that induced gall‐bladder contraction can be successfully applied as an adjuvant treatment in a subgroup of patients with small solitary gallstones.