Rawat B, Wolber R, Burhenne H J
Department of Radiology, University of British Columbia, Vancouver, Canada.
AJR Am J Roentgenol. 1991 Jan;156(1):73-6. doi: 10.2214/ajr.156.1.1701611.
Although delayed effects of renal extracorporeal shock-wave lithotripsy (ESWL) have been reported, the long-term soft-tissue effects after biliary ESWL have not been investigated. We report soft-tissue effects seen up to 1 year after biliary extracorporeal shock waves were administered to 18 Yucatan pigs. The gallbladder received 4000 electromagnetic shock waves from a Siemens Lithostar overhead module. Blood samples were drawn from each pig for hematologic, coagulation, and biochemical profiles immediately before and then at prescribed time intervals after administration of shock waves. Autopsy and histopathologic examination of the gallbladder and surrounding organs were performed. Kidneys and adrenal glands also were examined in five pigs followed up for 1 year. There were no gross or microscopic abnormalities in 11 animals, including all five animals in the 1-year group in which kidneys and adrenal glands also were normal. One animal (3-week group) had two 2-mm foci of parenchymal necrosis in the right lobe of the liver, probably related to ischemia after shock-wave therapy. Transient rise in liver and pancreatic enzyme levels was seen in most animals after administration of shock waves. The levels returned to normal within 2 months in all but one animal. We conclude that biliary ESWL with the Lithostar Plus does not produce long-term histologic evidence of organ damage in Yucatan pigs.
尽管已有关于肾体外冲击波碎石术（ESWL）延迟效应的报道，但尚未对胆道ESWL后的长期软组织效应进行研究。我们报告了对18只尤卡坦猪进行胆道体外冲击波治疗后长达1年观察到的软组织效应。胆囊接受了来自西门子Lithostar高架模块的4000次电磁冲击波。在冲击波给药前及给药后的规定时间间隔，从每只猪采集血样进行血液学、凝血和生化分析。对胆囊及周围器官进行尸检和组织病理学检查。还对5只随访1年的猪的肾脏和肾上腺进行了检查。11只动物未发现大体或显微镜下异常，包括1年组的所有5只动物，其肾脏和肾上腺也正常。1只动物（3周组）肝脏右叶有两个2毫米的实质坏死灶，可能与冲击波治疗后的缺血有关。大多数动物在冲击波给药后出现肝脏和胰腺酶水平短暂升高。除1只动物外，所有动物的水平在2个月内恢复正常。我们得出结论，使用Lithostar Plus进行胆道ESWL不会在尤卡坦猪身上产生器官损伤的长期组织学证据。
