Document Detail


Predictions and associations of cholecystectomy in patients with cholecystolithiasis treated with extracorporeal shock wave lithotripsy.
MedLine Citation:
PMID:  15628729     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 cholecystolithiasis 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 compared to patients with their gallbladder still in situ and determinants of cholecystemctomy in terms of clinical, stone, and gallbladder parameters and symptoms analyzed. 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 of 34 months (range, 0-127 months) after ESWL. Histological data showed a normal gallbladder wall in only 4 cases; 101 examinations revealed some kind of (chronic) 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 associated with persitent and/or renewed biliary symtoms. Nevertheless, only three of four patients became asymptomatic after CE. Thus, ESWL proved to be a valuable organ-preserving alternative to cholecystectomy in selected patients.
Authors:
H E Adamek; C Rochlitz; A C Von Bubnoff; D Schilling; J F Riemann
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  49     ISSN:  0163-2116     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:    2004 Nov-Dec
Date Detail:
Created Date:  2005-01-04     Completed Date:  2005-01-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1938-42     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Klinikum Ludwigshafen, Academic Hospital of Johannes Gutenberg University of Mainz, Ludwigshafen, Germany. adamek@klinikum-lev.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Child
Cholecystectomy / statistics & numerical data*
Cholecystolithiasis / therapy*
Female
Follow-Up Studies
Humans
Lithotripsy*
Male
Middle Aged
Prognosis
Recurrence
Retrospective Studies
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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