Abstract
Extracorporeal shock wave lithotripsy for gallstone (GS) using the second generation spark discharge system (MPL-9000, Dornier) was performed in 50 patients (Male 24, Female 26). They had 1-7 GS (range 4∼37 mm mean16.3 mm). After disintegration, the patients received adjuvant dissolution therapy, with ursodeoxycholic acid,600 mg/day orally. The results were as follow; 1) the average number of impulses were 1,704 shock waves, the average generation voltage was 17 kv.2) general or epidural anaesthesia for ESWL were replaced by intravenous pentazocine analgesia (80%) or no medication (20%). 3) in 46 cases of 50 patients (92%), stones could be disintegrated under 4 mm in diameter after ESWL.26% of the patients were retreated because of large residual fragments.4) after ESWL, transient hematuria occurred in 26 patients (52%). Transient increase of CPK (48%), transaminase (23%) were observed. Abo ut one tenth of the patients had episodes of biliary pain after ESWL.5) Endoscopic retrograde cholangiography was performed in 25 cases 3 days after ESWL. In 8 cases out of 25 patients, some fragments by ESWL were found in common bile duct.6) within a follow-up of 9 months after ESWL, stones were disappeared in 4 cases (8%) and nearly completely disappeared in 3 cases (6%). And diminished size and number of fragments group were 30 (60%). In conclusions, ESWL using second generation spark discharge system combined dissolution therapy could be a safe and effective treatment of cholesterol gallstones.
