Abstract
The indication for and effect of lithotripsy on gall bladder stones by an extracorporeal shock wave were investigated in clinical application with 200 gall stones cases after fundamental studies for the determination of impulse condition had been performed. The gallstones could be disintegrated in 193 cases (96.5%). Dissolution therapy was performed in 181 cases. An endoscopic sphincterotomy (ES) was also performed for three gallstone cases accompanied by common bile duct stones, four cases which were accompanied by acute pancreatitis and for prevention of complications in one case, respectively. Percutaneous transhepatic cholecystoscopy was performed for the excretion of stones in five cases including the cases of calcium-bilirubin stones, one case of calcified mixed stone, and one case having 20 stones. The stones disappeared in 60 cases (30%). The disappearrance rate for single stone having a diameter of less than 20 mm was 51.7%, and for ultrasonographically presumed cholesterol stone, the cumulative disappearance rate was 58.2% in two years. Important factors of maximum and minimum diameters of cystic duct for the stone disappearance were estimated in 49 cases in which stone disappeared and 40 cases in which they persisted for more than one year. There were significant differences both in the mean maximum diameter of 6.2±3.1mm and mean minimum diameter of 2.5±1.5mm in the stone disappcarance group, and the mean maximum diameter of 4.2±1.5mm and mean minimum diameter of 2.0±0.7mm in the persisted group(t-test). The number of required days for stone disappearance and the diameters of cystic ducts correlated with R: 0.388 for the maximum diameters and R: 0.359 for minimum diameters.
