1994
DOI: 10.1136/gut.35.1.117
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Gall stone pulverisation strategy in patients treated with extracorporeal lithotripsy and follow up results of maintenance treatment with ursodeoxycholic acid.

Abstract: Between November 1988 and July 1992 70 patients with radiolucent gall stones were treated with extracorporeal lithotripsy (ESL) and ursodeoxycholic acid (UDCA; mean (SD) dose 11-2 (1-9) mg/kg/day). Fifty three patients have been followed for one year. One week after lithotripsy, 30-6% had completely eliminated all stone fragments from the gall bladder and one year later 93*9% were free of stones. Three factors were considered important in achieving these results. 'Pulverisation' of the stone -that is, its frag… Show more

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Cited by 10 publications
(10 citation statements)
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“…Satisfactory fragmentation (defined by the persistence of fragments of no more than 5 mm (5)) seems to approximate 40-60%, although heterogeneity in reporting makes conclusions somewhat uncertain (5,126,128,(135)(136)(137)(138)(139)(140)(141)(142)(143)(144)(145)(146)(147)(148)(149)(150). Electrohydraulic generators have on average required fewer sessions than the other two generator types to achieve this endpoint (5).…”
Section: B the Medical Treatment Of Cholelithiasismentioning
confidence: 99%
See 1 more Smart Citation
“…Satisfactory fragmentation (defined by the persistence of fragments of no more than 5 mm (5)) seems to approximate 40-60%, although heterogeneity in reporting makes conclusions somewhat uncertain (5,126,128,(135)(136)(137)(138)(139)(140)(141)(142)(143)(144)(145)(146)(147)(148)(149)(150). Electrohydraulic generators have on average required fewer sessions than the other two generator types to achieve this endpoint (5).…”
Section: B the Medical Treatment Of Cholelithiasismentioning
confidence: 99%
“…Electrohydraulic generators have on average required fewer sessions than the other two generator types to achieve this endpoint (5). It would appear that the shock waves themselves are safe though they cause reversible enzymatie rises (126,(135)(136)(137)(138)(139)(140)(141)(142)(143)(144)(145)(146)(147)(148)(149)(150) Although in vitro data suggest the basis for a possible expansion of selection criteria on the basis of CT scan appearance (116), small, solitary, uncalcified stones are the most likely to fragment satisfactorily, and will do so 70% of the time (5). The resulting fragments are then treated by oral bile acids, which have been shown to accelerate the dissolution rate (151).…”
Section: B the Medical Treatment Of Cholelithiasismentioning
confidence: 99%
“…Namely, this concept of extracorporeal shockwave lithotripsy appears to be positioned as an extension of the concept of bile acid dissolution therapy. 3,12 On the other hand, a modified treatment procedure, "pulverization" has been reported more recently by Boscaini et al 19 and by Soehendra et al 2~ This involves the same procedure as our repeated lithotripsy with no limit to the total number of shockwaves and treatment sessions, and is carried out to achieve particularly fine disintegration of the stones. The pulverized fragments appear to be evacuated spontaneously and rapidly from the gallbladder, without the administration of bile acid agents.…”
Section: Discussionmentioning
confidence: 89%
“…A threshold energy exists for the stones below which no further fragmentation takes place. According to previous experiments, fragment layers in front of still intact stones or larger stone pieces may attenuate the acoustic energy to these levels [20][21][22].…”
Section: Discussionmentioning
confidence: 89%
“…According to previous experiments, fragment layers in front of still intact stones or larger stone pieces may attenuate the acoustic energy to these levels [20][21][22]. According to previous experiments, fragment layers in front of still intact stones or larger stone pieces may attenuate the acoustic energy to these levels [20][21][22].…”
Section: Discussionmentioning
confidence: 89%