Use of external shock-wave lithotripsy and adjuvant ursodiol for treatment of radiolucent gallstones |
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| Authors: | David Burnett MD Atilla Ertan MD Ronald Jones MD J. Patrick O'Leary MD Robert Mackie MD John E. Robinson Jr MD Gerald Salen MD Leroy Stahlgren MD David H. Van Thiel MD Louis Vassy MD Dr Norton J. Greenberger MD Alan F. Hofmann MD |
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| Affiliation: | (1) University of Nebraska Medical Center/Bishop Clarkson Hospital, Omaha, Nebraska;(2) Tulane University Medical Center, New Orleans, Louisiana;(3) Louisiana State University, New Orleans, Louisiana;(4) Abbott-Northwestern Hospital, Minneapolis, Minnesota;(5) Baptist Memorial Hospital, Memphis, Tennessee;(6) Cabrini Medical Center, New York, New York;(7) Saint Joseph Hospital, Denver, Colorado;(8) University of Pittsburgh, Pittsburgh, Pennsylvania;(9) Mount Carmel Hospital, Columbus, Ohio;(10) Department of Medicine, University of Kansas Medical Center, Rainbow Blvd at 39th, 66103 Kansas City, Kansas;(11) University of California at San Diego, La Jolla, California |
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| Abstract: | A prospective multicenter trial was performed to evaluate the use of external shockwave lithotripsy (ESL) and adjuvant medical therapy for the treatment of gallstones. A Medstone STS lithotripter was used together with ursodiol. Two hundred twenty-three patients were treated under general anesthesia (75%) or with intravenous analgesia (25%). Initial treatments were on an inpatient basis, but as centers gained experience, outpatient treatments became more common. Stone fragmentation and clearance were greatest in patients with solitary gallstones <2 cm in diameter. In this group of patients, stone fragmentation occurred in 97% of patients, and the cumulative stone-free rates at three and six months were 54% and 90%, respectively. These results indicate that fragmentation of gallstones can be achieved by a dry shock-wave lithotripter and that stone clearance is induced more rapidly by external shock-wave lithotripsy and adjuvant ursodiol therapy than by ursodiol therapy alone. |
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| Keywords: | external shock-wave lithotripsy gallstones multicenter trial |
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