Amstrup J H, Eldrup J, Wille-Jørgensen P A
Kirurgisk afdeling K., Bispebjerg Hospital, København.
Ugeskr Laeger. 1995 Apr 10;157(15):2143-6.
Fifteen patients with stones in the common bile duct, in whom treatment with endoscopic papillotomy and stone-extraction had been unsuccessful were treated with extracorporeal shockwave lithotripsy. Nine patients were stone-free after one or two sessions, and two patients after further endoscopic treatment. One patient achieved partial clearance and palliation. One patient had a choledochoduodenostomy performed due to ineffectiveness of the shockwave lithotripsy. Two patients, who were thought to have a stone, turned out to have neoplasma in the common bile duct. Complications were frequent but temporary and needed no treatment. We conclude that extracorporeal shockwave lithotripsy is a valuable and safe alternative in those cases where conventional endoscopic treatment has failed, and should be considered before operation, especially to old for high-risk patients.
15例胆总管结石患者经内镜乳头切开取石术治疗失败后,接受了体外冲击波碎石术。9例患者在接受一至两次治疗后结石消失,2例患者在进一步接受内镜治疗后结石消失。1例患者结石部分清除并缓解了症状。1例患者因冲击波碎石术无效而接受了胆总管十二指肠吻合术。2例被认为有结石的患者,结果发现胆总管内有肿瘤。并发症很常见,但都是暂时的,无需治疗。我们得出结论,在传统内镜治疗失败的情况下,体外冲击波碎石术是一种有价值且安全的替代方法,在手术前应予以考虑,尤其是对于高龄高危患者。