Extracorporeal shock wave lithotripsy of gallstones: Early experience in an Israeli population

Fifty-four patients with symptomatic gallbladder stones were treated by extracorporeal shock wave lithotripsy (ESWL) and oral bile acids on an outpatient basis. In 49 patients (90%), the stones were successfully fragmented to fragments < 5 mm on follow-up ultrasonography. Patients underwent 1-3 lithotripsy sessions with 7,500-9,750 shock waves per session. The gallbladder clearance rate of fragments was dependent mainly on the number of stones and reached 59% for patients with one or two stones, compared to 34% for patients with more than two stones after 9 months follow-up. The only side effects noted were mild abdominal pain, transient microscopic hematuria and minimal impairment in liver function tests. There were no serious complications such as cholecystitis, bile duct obstruction, or pancreatitis. These results, which are comparable with those of other groups using the same shock wave lithotriptor, indicate that this therapy may become an alternative treatment for selected patients with symptomatic gallbladder stones, especially those who are at high risk for surgical treatment.