Perkutan-transhepatische Litholyse — Indikation, Erfolge, Risiken

Decision-Making in Patients with Gallstones: Development of a Clinical Algorithm Using the Instrument of a Consensus Development Conference

“…Under these conditions within 1-3 years the mean dissolution rate is approximately 70% [60,[62][63][64], The disadvan tages of oral litholysis are patient selection, long treatment time and a recurrence rate 2-5 years after successful lysis of 25-50% (solitary stones recur less often than multiple ones) [66,67], From a surgical point of view only high risk patients with a considerable comorbidity and patients who choose to avoid operation should be selected for this long-term medical treatment which can also cause side effects such as diarrhea and increased liver enzymes. There are some newly developed techniques of direct litholysis using methyl-tert-butyl ether [68][69][70][71], These ap proaches are invasive and are still experimental tech niques with considerable morbidity and stone recurrence as high as known for oral litholysis [71], With regard to the rapidly growing experience and standards in performing laparoscopic cholecystectomy, direct ether lysis seems to be an obsolete treatment.…”