Staritz M, Grosse A, Alkier R, Krzoska B, Meyer zum Büschenfelde K H
I. Medizinische Klinik und Poliklinik, Johannes Gutenberg Universität, Mainz.
Z Gastroenterol. 1992 Feb;30(2):156-61.
Extracorporeal shock wave lithotripsy of extra- and intrahepatic bile duct stones is indicated after failure of conventional operative endoscopic procedures including mechanical lithotripsy. An overview of the current literature (12 centers, 568 patients) indicates that this novel procedure has attracted international acceptance. It was applied in elderly patients (means = 65 years) with solitary (37.5%) or multiple (62.5%) concrements. Clearance of the bile ducts was achieved in 71.6% after 1.3 to 3.0 lithotripsy sessions (1900-4000 shocks) if additional endoscopic sphincterotomy was performed. Without sphincterotomy 61% of patients were treated successfully. The most frequent side effects were macrohematuria (6.9%), hemobilia (6.2%) cholangitis (4.5%) and pancreatitis (1.3%). A lethality of 0-3.6% (means = 0.6%) was reported. The current results demonstrate that therapy of extra- and intrahepatic bile duct stones with extracorporeal shock wave lithotripsy is effective, safe and provides high therapeutic comfort.
在包括机械碎石术在内的传统手术内镜治疗失败后，可采用体外冲击波碎石术治疗肝内外胆管结石。当前文献综述（12个中心，568例患者）表明，这种新方法已获得国际认可。该方法应用于患有单个（37.5%）或多个（62.5%）结石的老年患者（平均年龄65岁）。如果同时进行内镜括约肌切开术，在进行1.3至3.0次碎石术（1900 - 4000次冲击）后，71.6%的患者胆管结石得以清除。若不进行括约肌切开术，61%的患者治疗成功。最常见的副作用为肉眼血尿（6.9%）、胆道出血（6.2%）、胆管炎（4.5%）和胰腺炎（1.3%）。报告的致死率为0 - 3.6%（平均为0.6%）。目前的结果表明，体外冲击波碎石术治疗肝内外胆管结石有效、安全且具有很高的治疗舒适度。
