下野 一子, 森 孝郎

Kazuko SHIMONO, Takao MORI

羽津病院外科

Department of Surgery, Hazu Hospital

キーワード : Gallbladder stone, Extracorporeal shock wave lithotripsy, Ultrasonography

From February 1989 to July 1990, fifty patients with gallbladder stones have been treated by extracorporeal shock wave lithotripsy (ESWL) using EDAP LT-01 piezoelectric lithotriptor. Patients were divided into four groups according to the nature of their gallstones, determined by an ultrasonic characteristics; group 1 was type Ia (Tsuchiya's classification), group 2 was type Ib pluse Ic, group 3 was type II and group 4 was type III.
Stones were successfully fragmented in 47 patients (94%). In these patients, the average of treatment sessions was 4.6 times. Two patients in group 3 and one patient in group 4 showed no disintegration after three treatment sessions. Complete disappearance or reduction of the fragments were showed by ultrasonography in 36 of 47 patients with sufficient fragmentation, and assessed as "treatment success". In group 1, the rate of treatment success was 90.9%, in group 2 82.4%, in group 3 64.3%, in group 4 60.0%. Therefore, gallbladder stones in group 1 and 2, meaning as cholesterol stones, were good candidates for ESWL therapy. However, the rates of treatment success were lower in patients in group 3 and 4, compared to patients in group 1 and 2. Then, patients in group 3 and 4 could not be good candidates for ESWL therapy.
These results suggested that ultrasonic imaging diagnosis of gallstones was useful for expectation of the efficacy of ESWL therapy.