Extracorporeal Shockwave Lithotripsy For Gallstones

Extracorporeal Shockwave Lithotripsy

Do you want to get rid of gallstones without surgery ,then Extracorporeal Shockwave Lithotripsy is an option for you.

Extracorporeal Shockwave Lithotripsy (ESWL) treatment is a non-surgical treatment for the removal of Gallstones. Gallstones are nothing but crystal like particles which grow into stones in the gallbladder. These may move to the biliary tract and block the flow of the bile and cause an increase in the pressure in the gallbladder. This results in one or more symptoms and you need to consult your doctor. This treatment uses shock waves to break the stones into small pieces so that they can flow through the bile without causing any obstruction.

Extracorporeal Shockwave Lithotripsy:

The patient has to sit in a tub of water. High-energy, ultrasound shock waves are passed through the abdominal wall towards the stones. These shock waves travel through the soft tissues of the body and help in breaking up of the stones. The pieces of stones are now small enough to be passed through the bile duct and into the intestines. Lithotripsy is generally done along with oral dissolution treatment to help dissolve the pieces of the original gallstone. Oral dissolution therapy uses some drugs made from bile acids to dissolve the stones.

Suitable Patients :

This treatment is more appropriate to those who cannot undergo surgery but this method is outdated and is not commonly used. This method works well on single stones which less than 2 cm in diameter. Less than 15 % of patients are suitable for this treatment.

Advantages:

  • Elderly people have lesser chance of recurrence than younger people and hence this treatment may be good choice for them.
  • When compared to open surgery it is more advantageous as it is an out patient treatment. And recovery time is less and the patient may attend his daily work very fast.
  • It is less painful to the patients.

Disadvantages:

  • Though the mortality rate is zero this treatment causes complications like pain in the gallbladder area and pancreatitis which usually occurs within a month of treatment.
  • The fragmented pieces may not completely be removed through the bile duct. Erythromycin has to be taken in the treatment regimen for complete removal. About 35 % of the patients who are not completely free from fragments may develop further complications which may be severe sometimes.
  • The possibility of recurrence of the stones is higher in this treatment and it is found that 45 % of patients needed surgery in one study. The recurrence is possible in 50 % of patients within 5 years.
  • This treatment is applicable to a very few  people.

 

The use of ESWL may finally depend on the willingness of the public or health care system to bear the additional costs of multiple treatments of gallstones during a person’s lifetime . The emergence of ESWL for treating gallstones has resulted in lot of criticism from the surgical community.