Eligibility for extracorporeal shock wave lithotripsy of gallbladder stones using different entry criteria.

Abstract

Extracorporeal shock wave lithotripsy (ESWL) was introduced as a nonsurgical treatment for uncomplicated, symptomatic gallstone disease. Due to its limited results and the possibility of stone recurrence, ESWL is mainly indicated for patients who reject or cannot tolerate cholecystectomy. For budgetary and planning purposes, it is essential to know what percentage of patients are eligible for this form of therapy. In the literature suitability is either reported variably (ranging from 10% to 53%) or not mentioned. We respectively assessed eligibility for ESWL for different entry criteria, based on the histories of 694 consecutive patients, who were referred for gallstone therapy from April 1, 1988 to October 1, 1991. Only 10.3%-46.9% of symptomatic patients were found eligible for ESWL, depending on the entry criteria used. When the overall results are compared with eligibility, there is no inverse relationship. This suggests that patient selection is not the only factor determining the results of therapy. It is concluded, therefore, that other factors, such as treatment schemes, the lithotripters used, and experience of the treating physicians, are important factors for the outcome of ESWL therapy.