Sackmann M, Ippisch E, Sauerbruch T, Holl J, Brendel W, Paumgartner G
Department of Medicine II, Ludwig-Maximilian-University, Munich, Federal Republic of Germany.
Gastroenterology. 1990 Feb;98(2):392-6. doi: 10.1016/0016-5085(90)90830-t.
Extracorporeal shock-wave lithotripsy combined with adjuvant bile-acid dissolution therapy results in complete clearance of stone fragments in a high percentage of selected patients with radiolucent gallbladder calculi. With the gallbladder in situ, these patients are at risk of stone recurrence. Therefore, the early rate of stone recurrence after successful lithotripsy was evaluated. Fifty-eight of the first 60 consecutive patients who became stone free underwent follow-up examinations at least 1 yr (range, 12-37 mo; mean +/- SD, 18 +/- 6) after discontinuation of adjuvant bile-acid therapy. Five patients reported recurrent biliary pain within 1 yr after lithotripsy, and recurrent gallstones were detected. Fifty-three patients were asymptomatic during the first yr, and no recurrence was detected. Thus, the rate of gallstone recurrence was 9% within 1 yr. The rate of gallstone recurrence up to 3 yr was estimated by actuarial analysis. The probability of stone recurrence was 11% (+/- 4%) at 1.5 yr, and no further increase was observed up to 3 yr. Gallstone recurrence within 1 yr after successful shock-wave therapy has to be expected in approximately the same percentage of patients as has been reported in earlier postdissolution trials. It causes recurrent biliary pain in most cases.
体外冲击波碎石术联合辅助胆汁酸溶解疗法可使大部分选定的透光性胆囊结石患者的结石碎片完全清除。由于胆囊仍保留在原位，这些患者有结石复发的风险。因此，对成功碎石术后结石复发的早期发生率进行了评估。在连续60例首次结石清除的患者中，有58例在停用辅助胆汁酸治疗后至少随访了1年（范围12 - 37个月；平均±标准差，18±6）。5例患者在碎石术后1年内报告有复发性胆绞痛，并检测到复发的胆结石。53例患者在第1年无症状，未检测到复发。因此，1年内胆结石复发率为9%。通过精算分析估计了长达3年的胆结石复发率。在1.5年时结石复发的概率为11%（±4%），直至3年未观察到进一步增加。成功冲击波治疗后1年内胆结石复发的患者比例与早期溶解术后试验报告的比例大致相同。在大多数情况下，它会引起复发性胆绞痛。
