Factors Affecting Gallstone Recurrence After Successful Extracorporeal Shock Wave Lithotripsy

Ochi, Hidenori; Tazuma, Susumu; Kajihara, Toshiki; Hyogo, Hideyuki; Sunami, Yasushi; Yasumiba, Shigeyuki; Nakai, Kuniharu; Tsuboi, Kazuhiko; Asamoto, Yasumasa; Sakomoto, Minoru; Kajiyama, Goro

doi:10.1097/00004836-200010000-00009

Cited by 11 publications

(8 citation statements)

References 13 publications

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“…Recurrence following ESWL is a problem as the 10-year recurrence rate has been estimated to be 54-60% [90,91], and patients with reduced gallbladder function are likelier to experience recurrence [92]. UDCA has also been reported to be effective for preventing recurrence [86,87].…”

Section: Commentarymentioning

confidence: 99%

Evidence-based clinical practice guidelines for cholelithiasis 2016

Tazuma

Unno²,

Igarashi³

et al. 2016

J Gastroenterol

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178

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Cholelithiasis is one of the commonest diseases in gastroenterology. Remarkable improvements in therapeutic modalities for cholelithiasis and its complications are evident. The Japanese Society of Gastroenterology has revised the evidence-based clinical practice guidelines for cholelithiasis. Forty-three clinical questions, for four categories-epidemiology and pathogenesis, diagnosis, treatments, and prognosis and complications-were selected, and a literature search was performed for the clinical questions with use of the MEDLINE, Cochrane, and Igaku Chuo Zasshi databases for the period between 1983 and June 2012. The guidelines were developed with use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. This article preferentially describes the clinical management of cholelithiasis and its complications. Following description of the diagnosis performed stepwise through imaging modalities, treatments of cholecystolithiasis, choledocholithiasis, and hepatolithiasis are introduced along with a flowchart. Since there have been remarkable improvements in endoscopic treatments and surgical techniques, the guidelines ensure flexibility in choices according to the actual clinical environment. The revised clinical practice guidelines are appropriate for use by clinicians in their daily practice.

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Section: Commentarymentioning

confidence: 99%

Evidence-based clinical practice guidelines for cholelithiasis 2016

Tazuma

Unno²,

Igarashi³

et al. 2016

J Gastroenterol

Self Cite

209

178

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“…Both Tsumita et al22 and Venneman et al23 give a clue that the probability of stone recurrence is significantly higher in patients with poor gallbladder contractility than in those with good contractility. Ochi et al24 provide a link that the rate of impaired gallbladder contractility was higher in ESWL patients with recurrence when compared with those with no recurrence. Our research gives another link that lithotrity may result in impaired gallbladder contractility, which functions as a bridge between lithotrity and stone recurrence.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for gallbladder contractility after cholecystolithotomy in elderly high-risk surgical patients

Wang¹,

Luo²,

Yan³

et al. 2017

CIA

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ObjectiveCholecystolithiasis is a common disease in the elderly patient. The routine therapy is open or laparoscopic cholecystectomy. In the previous study, we designed a minimally invasive cholecystolithotomy based on percutaneous cholecystostomy combined with a choledochoscope (PCCLC) under local anesthesia.MethodsTo investigate the effect of PCCLC on the gallbladder contractility function, PCCLC and laparoscope combined with a choledochoscope were compared in this study.ResultsThe preoperational age and American Society of Anesthesiologists (ASA) scores, as well as postoperational lithotrity rate and common biliary duct stone rate in the PCCLC group, were significantly higher than the choledochoscope group. However, the pre- and postoperational gallbladder ejection fraction was not significantly different. Univariable and multivariable logistic regression analyses indicated that the preoperational thickness of gallbladder wall (odds ratio [OR]: 0.540; 95% confidence interval [CI]: 0.317–0.920; P=0.023) and lithotrity (OR: 0.150; 95% CI: 0.023–0.965; P=0.046) were risk factors for postoperational gallbladder ejection fraction. The area under receiver operating characteristics curve was 0.714 (P=0.016; 95% CI: 0.553–0.854).ConclusionPCCLC strategy should be carried out cautiously. First, restricted by the diameter of the drainage tube, the PCCLC should be used only for small gallstones in high-risk surgical patients. Second, the usage of lithotrity should be strictly limited to avoid undermining the gallbladder contractility and increasing the risk of secondary common bile duct stones.

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“…These data are similar to those of the postdissolution trial by Tomida et al (18), who reported a cholecystectomy rate of 26%. Differences are partly explained by the patient number included in the respective trials: The smaller the trial size, the smaller the number of patients who were operated on (19)(20)(21). Our rates of CE are similar to the figures reported by Ahmed et al, who caried out a follow-up of patients after ESWL or CE (22).…”

Section: Discussionmentioning

confidence: 99%

Predictions and Associations of Cholecystectomy in Patients with Cholecystolithiasis treated with Extracorporeal Shock Wave Lithotripsy

et al. 2004

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Extracorporeal shock wave lithotripsy (ESWL) is effective in the treatment of symptomatic cholecystolithiasis in well-selected patients. We analyzed the predictors of cholecystectomy in a large series of gallstone patients after ESWL. This was a retrospective follow-up cohort-study of consecutive patients undergoing ESWL for symptomatic cholecystolithiasis over a 9-year period. It was possible to analyze a total of 297 patients; there were 211 women and 86 men, with a mean age of 52 years (range, 8-81 years). Patients that had been cholecystectomized after ESWL were compared to patients with their gallbladder still in situ and determinants of cholecystemctomy in terms of clinical, stone, and gallbladder parameters and symptoms analyzed. The mean duration of follow-up was 99 months (range, 27-134 months). During follow-up, 106 (36%) patients underwent a cholecystectomy at a mean of 34 months (range, 0-127 months) after ESWL. Histological data showed a normal gallbladder wall in only 4 cases; 101 examinations revealed some kind of (chronic) inflammation, which was not different from histological gallbladder results in patients without prior lithotripsy. Three gallbladder polyps were found, but no carcinoma. Cholecystectomy after ESWL of gallbladder stones was strongly associated with persitent and/or renewed biliary symtoms. Nevertheless, only three of four patients became asymptomatic after CE. Thus, ESWL proved to be a valuable organ-preserving alternative to cholecystectomy in selected patients.

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Factors Affecting Gallstone Recurrence After Successful Extracorporeal Shock Wave Lithotripsy

Cited by 11 publications

References 13 publications

Evidence-based clinical practice guidelines for cholelithiasis 2016

Evidence-based clinical practice guidelines for cholelithiasis 2016

Risk factors for gallbladder contractility after cholecystolithotomy in elderly high-risk surgical patients

Predictions and Associations of Cholecystectomy in Patients with Cholecystolithiasis treated with Extracorporeal Shock Wave Lithotripsy

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