J Korean Radiol Soc.  1994 Aug;31(2):261-266.

Piezoelectric Extracorporeal Lithotripsy of Gallbladder Stones: New Inclusion Criteria

• Park YH
• Choi BI
• Yoon YB
• Han JK
• Han MC
• Kim CW
• Shin YM
• Yoon YK

Abstract

PURPOSE
To establish the optimal inclusion criteria for the patients with gallbladder stones to extracorporeal shock wave lithotripsy(ESWL) by retrospectively analyzing our current results.
MATERIALS AND METHODS
Data obtained from 201 patients with gallbladder stones treated with ESWL and oral chemolytic agent from November 1989 to July 1992 were restroepectively analyzed. Ninety-six had radiolucent stones and 105 had radiopaque stones. We used piezoelectric lithotriptor(EDAP LT. 01) and there were no limitation in number of sessions or total number of shock waves. ESWL was repeated until the size of the largest fragment is smaller than 4 mm. Follow up ultrasound was done in every three months after the successful fragmentation. Average length of the follow up was 205 days. We analyzed the rate of successful fragmentation, number of shock waves needed to achieve successful fragmentation according to the size, number of stones as well as the presence of the calcification. Stone-free rate after 6 months was also calculated from all subgroups and compared to each other.
RESULTS
The rate of successful fragmentation was 76.2% for radiolucent stones and 66.6% for radiopaque stones(p > 0.05) after 46,731 and 56,111 shock waves respectively(p > 0.05). The rate of successful fragmentation was highest in patients with single, radiolucent stone smaller than 2cm(91.7%) followed by single radiolucent stone larger than 2cm(83.3%), multiple calcified stones smaller than 2cm(77.4%) and single calcified stone smaller than 2cm(72.1%). The rate of complete stone clearance after 6 month follow-up was highest in patients with single radiolucent stone smaller than 2cm(63.3%) and followed by multiple calcified stones smaller than 2cm(37.3%), single calcified stone smaller than 2cm(33.9%)(p <0.05).
CONCLUSION
To obtain better results with ESWL in patients with gallbladder stone, the authors propose a more strict inclusion criteria, which is the patient with a single, radiolucent stone smaller than 2cm.

MeSH Terms

Follow-Up Studies
Gallbladder*
Humans
Lithotripsy*
Retrospective Studies
Shock
Ultrasonography