Long-Term Follow-Up After Treatment of Common Bile Duct Stones by Extracorporeal Shock-Wave Lithotripsy
| Autor: | Michel-Harder C, Bühler H, R. Münch, Christa Meyenberger, Wirth Hp, Meierhofer U, Knuchel J, Altorfer J |
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| Rok vydání: | 1996 |
| Předmět: |
Adult
Male medicine.medical_specialty Long term follow up medicine.medical_treatment Gallstones Lithotripsy Extracorporeal medicine Humans Hospital Mortality Microhematuria Aged Retrospective Studies Aged 80 and over Common bile duct business.industry Bile duct Mortality rate Gastroenterology Middle Aged medicine.icd_9_cm_classification Extracorporeal shock wave lithotripsy Surgery Treatment Outcome medicine.anatomical_structure Female business Follow-Up Studies |
| Zdroj: | Endoscopy. 28:411-417 |
| ISSN: | 1438-8812 0013-726X |
| DOI: | 10.1055/s-2007-1005502 |
| Popis: | Background and Study Aims : The efficacy of extracorporeal shock-wave lithotripsy (ESWL) of difficult bile duct stones that were not amenable to routine endoscopic extraction was assessed, with evaluation of the long-term follow-up after successful treatment. Patients and Methods : Fifty-four patients (mean age 74 years, range 33-92) were treated with ESWL for difficult bile duct stones. Treatment was performed either with the Dornier HM3 kidney lithotriptor (49 patients) or with the MPL 9000 lithotriptor (five patients). Results : Stone disintegration was achieved in 50 patients (93%), with complete stone clearance in 45 patients (83 %) (mean 1.2 sessions). Patients with successful stone removal after one session had significantly smaller stones than patients with treatment failure (20 ± 9 versus 27 ± 8 mm ; p < 0.05). An intrahepatic location of stones was significantly associated with treatment failure (p< 0.005). Severe complications occurred in 7% (procedure-related 5%), with a 30-day mortality rate of 0% (in-hospital mortality rate of 2%). Minor side effects such as fever, petechiae, and mild arrhythmias were frequent (37%), and microhematuria (94%) occurred in nearly all of the patients. Symptomatic recurrent bile duct stones were observed in two patients (5 %) after three and four years, respectively (mean follow-up 5.3 years). Conclusion : Extracorporeal shock wave lithotripsy represents a safe and effective treatment modality for difficult bile duct stones, with a low rate of symptomatic recurrences. |
| Databáze: | OpenAIRE |
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