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Use of external shock-wave lithotripsy and adjuvant ursodiol for treatment of radiolucent gallstones

A national multicenter study

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Abstract

A prospective multicenter trial was performed to evaluate the use of external shockwave lithotripsy (ESL) and adjuvant medical therapy for the treatment of gallstones. A Medstone STS lithotripter was used together with ursodiol. Two hundred twenty-three patients were treated under general anesthesia (75%) or with intravenous analgesia (25%). Initial treatments were on an inpatient basis, but as centers gained experience, outpatient treatments became more common. Stone fragmentation and clearance were greatest in patients with solitary gallstones <2 cm in diameter. In this group of patients, stone fragmentation occurred in 97% of patients, and the cumulative stone-free rates at three and six months were 54% and 90%, respectively. These results indicate that fragmentation of gallstones can be achieved by a dry shock-wave lithotripter and that stone clearance is induced more rapidly by external shock-wave lithotripsy and adjuvant ursodiol therapy than by ursodiol therapy alone.

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Authors and Affiliations

  1. University of Nebraska Medical Center/Bishop Clarkson Hospital, Omaha, Nebraska

    David Burnett MD, Atilla Ertan MD, Ronald Jones MD, J. Patrick O'Leary MD, Robert Mackie MD, John E. Robinson Jr MD, Gerald Salen MD, Leroy Stahlgren MD, David H. Van Thiel MD, Louis Vassy MD,  Norton J. Greenberger MD (Co-monitor) & Alan F. Hofmann MD (Co-monitor)

  2. Tulane University Medical Center, New Orleans, Louisiana

    David Burnett MD, Atilla Ertan MD, Ronald Jones MD, J. Patrick O'Leary MD, Robert Mackie MD, John E. Robinson Jr MD, Gerald Salen MD, Leroy Stahlgren MD, David H. Van Thiel MD, Louis Vassy MD,  Norton J. Greenberger MD (Co-monitor) & Alan F. Hofmann MD (Co-monitor)

  3. Louisiana State University, New Orleans, Louisiana

    David Burnett MD, Atilla Ertan MD, Ronald Jones MD, J. Patrick O'Leary MD, Robert Mackie MD, John E. Robinson Jr MD, Gerald Salen MD, Leroy Stahlgren MD, David H. Van Thiel MD, Louis Vassy MD,  Norton J. Greenberger MD (Co-monitor) & Alan F. Hofmann MD (Co-monitor)

  4. Abbott-Northwestern Hospital, Minneapolis, Minnesota

    David Burnett MD, Atilla Ertan MD, Ronald Jones MD, J. Patrick O'Leary MD, Robert Mackie MD, John E. Robinson Jr MD, Gerald Salen MD, Leroy Stahlgren MD, David H. Van Thiel MD, Louis Vassy MD,  Norton J. Greenberger MD (Co-monitor) & Alan F. Hofmann MD (Co-monitor)

  5. Baptist Memorial Hospital, Memphis, Tennessee

    David Burnett MD, Atilla Ertan MD, Ronald Jones MD, J. Patrick O'Leary MD, Robert Mackie MD, John E. Robinson Jr MD, Gerald Salen MD, Leroy Stahlgren MD, David H. Van Thiel MD, Louis Vassy MD,  Norton J. Greenberger MD (Co-monitor) & Alan F. Hofmann MD (Co-monitor)

  6. Cabrini Medical Center, New York, New York

    David Burnett MD, Atilla Ertan MD, Ronald Jones MD, J. Patrick O'Leary MD, Robert Mackie MD, John E. Robinson Jr MD, Gerald Salen MD, Leroy Stahlgren MD, David H. Van Thiel MD, Louis Vassy MD,  Norton J. Greenberger MD (Co-monitor) & Alan F. Hofmann MD (Co-monitor)

  7. Saint Joseph Hospital, Denver, Colorado

    David Burnett MD, Atilla Ertan MD, Ronald Jones MD, J. Patrick O'Leary MD, Robert Mackie MD, John E. Robinson Jr MD, Gerald Salen MD, Leroy Stahlgren MD, David H. Van Thiel MD, Louis Vassy MD,  Norton J. Greenberger MD (Co-monitor) & Alan F. Hofmann MD (Co-monitor)

  8. University of Pittsburgh, Pittsburgh, Pennsylvania

    David Burnett MD, Atilla Ertan MD, Ronald Jones MD, J. Patrick O'Leary MD, Robert Mackie MD, John E. Robinson Jr MD, Gerald Salen MD, Leroy Stahlgren MD, David H. Van Thiel MD, Louis Vassy MD,  Norton J. Greenberger MD (Co-monitor) & Alan F. Hofmann MD (Co-monitor)

  9. Mount Carmel Hospital, Columbus, Ohio

    David Burnett MD, Atilla Ertan MD, Ronald Jones MD, J. Patrick O'Leary MD, Robert Mackie MD, John E. Robinson Jr MD, Gerald Salen MD, Leroy Stahlgren MD, David H. Van Thiel MD, Louis Vassy MD,  Norton J. Greenberger MD (Co-monitor) & Alan F. Hofmann MD (Co-monitor)

  10. Department of Medicine, University of Kansas Medical Center, Rainbow Blvd at 39th, 66103, Kansas City, Kansas

    David Burnett MD, Atilla Ertan MD, Ronald Jones MD, J. Patrick O'Leary MD, Robert Mackie MD, John E. Robinson Jr MD, Gerald Salen MD, Leroy Stahlgren MD, David H. Van Thiel MD, Louis Vassy MD,  Norton J. Greenberger MD (Co-monitor) & Alan F. Hofmann MD (Co-monitor)

  11. University of California at San Diego, La Jolla, California

    David Burnett MD, Atilla Ertan MD, Ronald Jones MD, J. Patrick O'Leary MD, Robert Mackie MD, John E. Robinson Jr MD, Gerald Salen MD, Leroy Stahlgren MD, David H. Van Thiel MD, Louis Vassy MD,  Norton J. Greenberger MD (Co-monitor) & Alan F. Hofmann MD (Co-monitor)

Authors
  1. David Burnett MD
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  2. Atilla Ertan MD
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  3. Ronald Jones MD
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  4. J. Patrick O'Leary MD
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  5. Robert Mackie MD
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  6. John E. Robinson Jr MD
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  7. Gerald Salen MD
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  8. Leroy Stahlgren MD
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  9. David H. Van Thiel MD
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  10. Louis Vassy MD
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  11. Norton J. Greenberger MD
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  12. Alan F. Hofmann MD
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Burnett, D., Ertan, A., Jones, R. et al. Use of external shock-wave lithotripsy and adjuvant ursodiol for treatment of radiolucent gallstones. Digest Dis Sci 34, 1011–1015 (1989). https://doi.org/10.1007/BF01536365

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  • DOI: https://doi.org/10.1007/BF01536365

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