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Extracorporeal shock-wave lithotripsy prior to laparoscopic cholecystectomy

✍ Scribed by V. Lange; G. Meyer; H. M. Schardey; M. Neubrandt; U. Klüppelberg

Publisher
Springer
Year
1994
Tongue
English
Weight
352 KB
Volume
8
Category
Article
ISSN
0930-2794

No coin nor oath required. For personal study only.

✦ Synopsis

The extraction of large gallstones in laparoscopic cholecystectomy either requires the enlargement of one of the incisions or intraoperative lithotripsy. Preoperative extracorporeal shock-wave lithotripsy (ESWL) might theoretically solve the problem and facilitate the extraction of the gallbladder.

Ten patients with at least one gallstone larger than 20 mm in diameter underwent ESWL treatment within 24 h prior to laparoscopic surgery. Complete pulverization of stones was achieved in one patient. Fragmentation into pieces smaller than 10 mm could be observed in another three cases. Additional mechanical fragmentation employing forceps was necessary in seven and an enlargement of the incision in five of the 10 patients. Compared to a matched group of 10 control patients with gallstones of corresponding size receiving mechanical lithotripsy, the ESWL did not show an advantage, but rather an increase in costs. It therefore cannot be recommended.

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