[Does the lithotripter change gallstone surgery?].

Extracorporeal shock-wave lithotripsy (ESWL) is a new method for treating gallstones. ESWL is an alternative method to cholecystectomy for treating symptomatic gallbladder stones--complicated cases excluded--in about 15% of all cases. The risk of stone recurrence with all its consequences (symptoms, complications, late mortality) has to be weighed against the higher morbidity and mortality of surgical treatment. ESWL can be used for bile duct stones instead of endoscopy. Concrements cannot be removed mechanically (10-20%) have been treated with a high success rate (80%) using ESWL. In summary, at present ESWL is restricted to a small number of selected cases.