Résumé
Depuis 1986, la lithotritie par ondes de choc extra-corporelles (L.O.C.E.) est présentée comme une alternative à la chirurgie dans le traitement des calculs biliaires. Depuis cette date, plusieurs milliers de patients de par le monde ont bénéficié de cette thérapeutique. L’ensemble de l’information dont nous disposons nous conduit à croire en l’inocuité et l’efficacité de la L.O.C.E. dans e traitement de nombreux patients porteurs de calculs biliaires. L’administration de médicaments litholithiques paraît la composante complémentaire importante de cette méthode.
La L.O.C.E. est également très efficace dans la lithiase cholédocienne et constitue le premier recours thérapeutique après échec d’une première tentative de traitement endoscopique ou chirurgical.
Dans la « cholangiolithiase orientale », chez les patients porteurs de calculs intra-hépatiques, les premiers résultats de la L.O.C.E. confère à cette technique non invasive, un rôle complémentaire par rapport aux autres méthodes de traitement de cette affection.
Summary
Extracorporeal shock wave lithotripsy has been used since 1986 as an alternative to surgery for the treatment of gallstone disease. Since then several thousand patients have been treated throughout the world. All the information to date suggests that extracorporeal shock wave lithotripsy will in many patients be a safe and effective method of dealing with uncomplicated gallbladder stone disease. Litholytic drugs appear to be an important adjuvent to the procedure.
Extracorporeal shock wave lithotripsy of bile duct stones is highly effective and can be considered in patients in whom primary endoscopic or surgical stone removal fails.
First clinical experiences with extracorporeal shock wave lithotripsy in cases of intrahepatic calculi due to oriental cholangiolithiasis suggest a complementary role of this non invasive technique in the treatment of this disease.
Resumen
La litotricia extracorpórea por ondas de choque (L.E.O.C.) se utiliza desde 1986 como alternativa a la Cirugía en el tratamiento de los cálculos biliares. Desde entonces, miles de pacientes de todo el mundo se han beneficiado de dicho tratamiento. Por la informatión de que disponemos hasta la actualidad creemos que la L.E.O.C. será un método eficaz y sin peligro útil para tratar a pacientes con cálculos biliares no complicados. Los medicamentos litolíticos paracen representor un componente complementario importante en éste procedimiento.
La L.E.O.C. de los cálculos coledocales es muy eficaz y puede indicarse en los pacientes en los que un primer intento de tratamiento quirúrgico o endoscópico ha fracasado.
Las primeras experiencias clínicas de L.E.O.C. en casos de cálculos intrahepáticos, realizadas en paises orientates, sugieren otra posibilidad más de empleo de ésta técnica en el tratamiento de la litiasis biliar.
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Heinrich, R.C., Schreckenberg, A., Cho, KS. et al. Expérience européenne de la lithotritie biliaire par ondes de choc. Acta Endosc 20, 513–525 (1990). https://doi.org/10.1007/BF02966781
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DOI: https://doi.org/10.1007/BF02966781