Document Detail


ESWL for difficult bile duct stones: a 15-year single centre experience.
MedLine Citation:
PMID:  20806432     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To evaluate the efficacy of extracorporeal shock wave lithotripsy (ESWL) for the management of refractory bile duct cholelithiasis in a third level referral centre.
METHODS: The clinical records of all patients treated with a second generation electromagnetic lithotripter (Lithostar Plus, SIEMENS) from October 1990 to April 2005 were evaluated. All patients were monitored during the procedure and antibiotics were administered in case of cholangitis. The chi(2) test and logistic regression analysis were performed as appropriate.
RESULTS: Two hundred and fourteen patients (102 males, 112 females; mean age 74.8 +/- 0.84 years--single stone 97, multiple stones 117) underwent ESWL. The mean number of sessions and shock waves were 3.5 +/- 0.13 and 3477.06 +/- 66.17, respectively. The maximum stone size was 5 cm. Complete stone clearance was achieved in 192 (89.7%) patients. Of the remaining patients 15 required surgery, 2 a palliative stent and in 5 patients stone fragmentation led to effective bile drainage with clinical resolution despite incomplete clearance. Age, sex and stone characteristics were not related to treatment outcome. Major complications occurred in two patients (haemobilia and rectal bleeding) and minor complications in 25 (3 vomiting, 22 arrhythmias). No procedure-related deaths occurred.
CONCLUSION: ESWL is a safe and effective technique for clearance of refractory bile duct stones.
Authors:
Rosangela Muratori; Francesco Azzaroli; Federica Buonfiglioli; Flavio Alessandrelli; Paolo Cecinato; Giuseppe Mazzella; Enrico Roda
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  16     ISSN:  1007-9327     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-31     Completed Date:  2010-12-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  4159-63     Citation Subset:  IM    
Affiliation:
Department of Digestive Diseases and Internal Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy. rosangela.muratori@aosp.bo.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Choledocholithiasis / therapy*
Female
Hemobilia / etiology
Hemorrhage / etiology
Humans
Lithotripsy* / adverse effects
Longitudinal Studies
Male
Middle Aged
Severity of Illness Index
Treatment Outcome

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