cqvip:Extracorporeal shock wave lithotripsy (ESWL) is effective in the treatment of symptomatic cholecystolithiasis in well- selected patients. We analyzed the predictors of cholecystectomy in a large series of gallstone patients after ESWL. This was a retrospective follow- up cohort- study of consecutive patients undergoing ESWL for symptomatic chole cystolithiasis over a 9- year period. It was possible to analyze a total of 297 patients; there were 211 women and 86 men, with a mean age of 52 years (range, 8- 81 years). Patients that had been cholecystectomized after ESWL were compare d to patients with their gallbladder still in situ and determinants of cholecyst emctomy in terms of clinical, stone, aid gallbladder parameters and symptoms ana lyzed. The mean duration of follow- up was 99 months (range, 27- 134 months). During follow- up, 106 (36% ) patients underwent a cholecystectomy at a mean o f 34 months (range, 0- 127 months) after ESWL. Histological data showed a norma l gallbladder wall in only 4 cases; 101 examinations revealed some kind of (chro nic) inflammation, which was not different from histological gallbladder results in patients without prior lithotripsy. Three gallbladder polyps were found, but no carcinoma. Cholecystectomy after ESWL of gallbladder stones was strongly ass ociated with persitent and/or renewed biliary symtoms. Nevertheless, only three of four patients became asymptomatic after CE. Thus, ESWL proved to be a valuabl e organ- preserving alternative to cholecystectomy in selected patients.
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