[Shockwave treatment of gallbladder stones. Current status of therapy].

Aims: Analysis of the results of piezoelectric lithotripsy of gallstones combined with subsequent dissolution therapy using chenodeoxycholic acid and ursodeoxycholic acid.

Design Of Study: Retrospective evaluation after 2 1/2 years application in the department; prospective study for stone recurrence with ASA.

Patients: A total of 246 patients with gallbladder stones selected on the basis of the Munich criteria; 171 patients were followed up for at least 24 months.

Results: With piezoelectric shockwave lithotripsy treatment can mostly be carried out without the need for analgesia. When the indication is strictly applied, a stone-free rate of almost 90% after one year can be achieved. To achieve this, regular use of bile acids for dissolution of the fragments remaining after lithotripsy is required. At the present time, our recurrence rate is around 14% after one and two years. The use of acetylsalicylic acid recurrent stone prophylaxis was of no benefit.

Conclusions: Extracorporeal shockwave lithotripsy now forms a permanent part of the conservative therapeutic approach to cholecystolithiasis. The results obtained are largely dependent upon an accurate indication. Particularly suitable patients are those with solitary cholesterol stones in a properly functioning gallbladder.