Capdeville R, André-Bougaran J, Barrat F, Moreaux J
Service de Radiologie, Centre Médico-Chirurgical de la Porte de Choisy, Paris.
Gastroenterol Clin Biol. 1990;14(2):120-3.
Experimental extracorporeal shock wave lithotripsy of gallstones was performed with the EDAP LT 01 piezoelectric lithotripter. Fragmentation of biliary stones was evaluated after implantation of human stones inside the gallbladder in 10 pigs. Lithotripsy was performed with a firing frequency of 2.5 shots per second during a mean time of 50 min. Zero to 18 days after lithotripsy, complete fragment clearance was seen in 6 cases, fragments less than 2 mm were found in 2 cases and fragments larger than 2 mm with only 1 non fragmented stone in 2 cases. There were no stone fragments in the cystic and common ducts. Damage to gallbladder and adjacent organs was appreciated after lithotripsy to the empty gallbladder of pigs with firing frequencies from 40 to 1.25 shots per second. Perforation of the gallbladder was observed in both pigs treated with a firing frequency of 40 shots per second and in 1 pig out of 3 treated with a firing frequency of 20 shots per second. With 10 shots per second and lower firing frequencies, mild histological changes of the gallbladder walls were only observed in 3 cases reoperated on the 2nd day after lithotripsy. The gallbladder wall was normal in the 5 cases reoperated on the 15th day and there were no hepatic, duodenal and pancreatic lesions. These experimental results are consistent with utilization of this machine in the treatment of gallstones in man; low firing frequencies are effective for fragmentation of gallstones without any adverse effects.
采用EDAP LT 01型压电碎石机对胆结石进行体外冲击波碎石实验。在10头猪的胆囊内植入人体结石后，评估胆石的破碎情况。碎石时的发射频率为每秒2.5次，平均持续时间为50分钟。碎石后0至18天，6例结石完全清除，2例发现小于2毫米的碎片，2例发现大于2毫米的碎片且仅有1颗未破碎结石。胆囊管和胆总管内无结石碎片。对猪的空胆囊以每秒40至1.25次的发射频率进行碎石后，观察到胆囊及相邻器官有损伤。发射频率为每秒40次的2头猪以及发射频率为每秒20次的3头猪中的1头均观察到胆囊穿孔。发射频率为每秒10次及更低时，仅在碎石后第2天再次手术的3例中观察到胆囊壁有轻微组织学改变。在第15天再次手术的5例中，胆囊壁正常，且无肝脏、十二指肠和胰腺损伤。这些实验结果与该机器在人类胆结石治疗中的应用情况相符；低发射频率对胆石破碎有效且无任何不良反应。
