Repeated piezoelectric lithotripsy for gallstones with and without ursodeoxycholic acid dissolution: a multicenter study
| Autor: | Sagawa H, Masao Otho, Hiroshi Tanimura, Terufumi Sakai, Yoshikazu Akura, Hajime Koshiyama, Yoshihiro Sugimoto, Saburo Nakazawa, Masahiro Morita, Mitsuo Shoji, Hideki Wakamatsu, Osamu Takahara, Keiichi Sugiyama, Michiko Nakajima, Goro Kajiyama, Kyoichiro Nishina, Minoru Harada, Yukihiro Kono, Kayoko Sone, Susumu Tazuma, Masabumi Hihara, Tomoo Takamura, Fumitake Ishihara, Yukio Kawai, Yukihiro Tsuchiya |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.drug_class medicine.medical_treatment Urology Gallbladder Stone Lithotripsy Gastrointestinal Agents Cholelithiasis Medicine Humans Prospective Studies Bile acid business.industry Ursodeoxycholic Acid Gastroenterology Gallstones Middle Aged medicine.disease Combined Modality Therapy Colorectal surgery Ursodeoxycholic acid Surgery Treatment Outcome Multicenter study Female business Abdominal surgery medicine.drug Follow-Up Studies |
| Zdroj: | Journal of gastroenterology. 30(6) |
| ISSN: | 0944-1174 |
| Popis: | The use of bile acid dissolution therapy in extracorporeal shockwave lithotripsy of gallstones, remains controversial. Our study examined whether chemolitholysis after sufficient disintegration enhanced stone clearance within 6 months of the first lithotripsy. A total of 143 patients who developed one to three radiolucent stones measuringor = 30 mm in diameter were randomly separated into two treatment groups: 47% were given lithotripsy alone, and 53% lithotripsy plus ursodeoxycholic acid (UDCA). Repeated piezoelectric lithotripsy was given, with no limit on the total number of treatment sessions, to pulverize or disintegrate stones into fragments3 mm. Stones were disintegrated in 97% of all patients, and the fragments wereor = 2 mm in 50% of these patients. According to an intention-to-treat analysis, 52% in the lithotripsy alone group and 58% in the UDCA group were free of stones 6 months after the first lithotripsy (P = 0.61). Of the patients with fragmentsor = 2 mm, 71% in the former and 86% in the latter group were free of stones 6 months after the first lithotripsy, with no significant difference between the groups. Biliary pain occurred in 25% of all patients, including 3 with acute cholecystitis. We concluded that the sufficient disintegration of gallstones achieved with repeated lithotripsy enhanced the early clearance of fragments, regardless of whether chemolitholysis was employed. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink