Gallbladder Stones: Indications and Limits of Extracorporeal Shock Wave Lithotripsy

From August 1, 1987, until December 31, 1987, we treated 66 selected patients with gallbladder stones by extracorporeal shock wave lithotripsy, using the Siemens Lithostar. General anesthesia was never used; analgesia with sedatives was given to 34 patients. In the remaining patients, no drugs were employed. Visualization of the gallbladder was obtained using oral or intravenous contrast media. The stones were focused using a biplane fluoroscopic system with the patients in the prone position. Fragmentation of the stones was obtained after the first session of ESWL in six patients, after two treatments in 13 patients, after three treatments in ten patients, and after four treatments in 11 patients. In 26 patients treatments were ineffective. We observed two cases of mild, transient pancreatitis that were treated by endoscopic sphincterotomy.