Burhenne H J, Becker C D, Malone D E, Rawat B, Fache J S
Department of Radiology, University of British Columbia, Vancouver, Canada.
Radiology. 1989 May;171(2):363-7. doi: 10.1148/radiology.171.2.2649916.
One hundred six patients underwent extracorporeal shock wave lithotripsy for cholelithiasis. Of these, 28 patients underwent cholangiographically guided lithotripsy for bile duct stones to assist nonoperative stone removal by endoscopic or radiologic intervention. Fragmentation occurred in 20 of 28 cases (71%) with an average of two lithotripsy sessions. Hemobilia was observed in four patients (14%) for a 24-hour period. Seventy-eight of the 106 were outpatients with symptomatic cholecystolithiasis with one to five calculi who underwent cholecystographic or ultrasound-(US) guided shock wave lithotripsy as definitive therapy. US examination showed stone fragmentation in 86% of cases. With an average of 1.6 treatment sessions and 4,750 shocks, fragments were 4 mm or smaller in 46% of patients. Nine percent of patients had no fragments after an average of 10 weeks, but long-term follow-up is not yet available. Two patients developed acute pancreatitis attributable to fragment passage and one patient acute cholecystitis, likely due to cystic duct obstruction by a fragment.
106例患者接受了体外冲击波碎石术治疗胆结石。其中，28例患者接受了胆管造影引导下的胆管结石碎石术，以辅助通过内镜或放射学干预进行非手术取石。28例中有20例（71%）发生结石破碎，平均进行了两次碎石治疗。4例患者（14%）在24小时内出现了胆道出血。106例患者中有78例为有症状的胆囊结石门诊患者，有1至5枚结石，他们接受了胆囊造影或超声（US）引导下的冲击波碎石术作为确定性治疗。超声检查显示86%的病例结石破碎。平均进行1.6次治疗，4750次冲击，46%的患者结石碎片小于或等于4毫米。平均10周后，9%的患者没有结石碎片，但尚未进行长期随访。两名患者因碎片通过而发生急性胰腺炎，一名患者发生急性胆囊炎，可能是由于碎片阻塞胆囊管所致。
