Lindström E, Borch K, Kullman E P, Tiselius H G, Ihse I
Department of Surgery, University Hospital, Linköping, Sweden.
Gut. 1992 Oct;33(10):1416-20. doi: 10.1136/gut.33.10.1416.
Extracorporeal shock wave lithotripsy treatment with Dornier HM3 or MPL 9000 machines was applied in 37 patients with problematic bile duct stones. General anaesthesia was not required. After one extracorporeal shock wave lithotripsy session 14/37 patients (38%) were spontaneously stone free, and additional endoscopic extraction (eight of 37) and retreatments with extracorporeal shock wave lithotripsy (seven cases) increased the stone free rate to 29/37 (78%). In three patients with intrahepatic stones, the bile ducts could not be evaluated decisively at cholangiography and ultrasonography, but they were all symptom free at 15 to 38 months follow up. If these three patients are added to the radiologically stone free patients, the overall clinical success rate was 32/37 (86%). There were no serious complications, hospital admissions, or 30 day mortality as a result of extracorporeal shock wave lithotripsy or endoscopic procedures. It is concluded that extracorporeal shock wave lithotripsy is a valuable adjunct to the non-surgical treatment of bile duct stones.
采用多尼尔HM3或MPL 9000型机器对37例胆管结石患者进行体外冲击波碎石治疗。无需全身麻醉。在一次体外冲击波碎石治疗后，14/37例患者（38%）结石自行排出，另外通过内镜取石（37例中的8例）和再次进行体外冲击波碎石治疗（7例）使结石清除率提高到29/37（78%）。在3例肝内结石患者中，胆管造影和超声检查无法明确评估胆管情况，但在15至38个月的随访中他们均无症状。如果将这3例患者纳入影像学检查结石已清除的患者中，总体临床成功率为32/37（86%）。体外冲击波碎石或内镜操作未导致严重并发症、住院或30天死亡率。结论是，体外冲击波碎石是胆管结石非手术治疗的一种有价值的辅助手段。
