Induced gall-bladder contraction accelerates fragment clearance after extracorporeal shockwave lithotripsy |
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Authors: | DIETER J. ZIEGENHAGEN ELMAR ZEHNTER WOLFGANG KRUIS CHRISTOPH POHL |
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Affiliation: | Clinic I of Internal Medicine, University of Cologne, Cologne, Germany |
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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. |
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Keywords: | ceruletide gall-bladder contraction gallstones lithotripsy |
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