Long-term results after successful extracorporeal gallstone lithotripsy: outcome of the first 120 stone-free patients

Scand J Gastroenterol. 2001 Mar;36(3):314-7. doi: 10.1080/003655201750074690.


Background: Long-term results after successful extracorporeal shock wave lithotripsy (ESWL) of symptomatic gallbladder stones are determined by stone and complaint recurrence. The long-term outcomes of the first successfully treated patients of our Department are presented.

Methods: The first consecutive 120 patients with symptomatic gallbladder stones who became stone-free after ESWL plus oral bile acids in the years 1986 and 1987 were included in this study. They were followed up at 1-to 2-year intervals clinically and by ultrasonography until April 1998. Recurrence of stones and biliary symptoms and subsequent treatment were recorded. The effect of various factors on recurrence was analyzed.

Results: Median follow-up time was 6.0 years for all patients and 8.8 years for patients without recurrence (range, 0-11.2 years for both). Actuarial recurrence probability was 1.9%-16.6% per year reaching 60.2% (49.9%, 70.3%) (95% confidence interval) after 10 years. Patients with stone recurrence revealed significantly more stones before ESWL than patients without recurrence (P < 0.03). Other factors were not significantly different. The majority of stone recurrences were symptomatic requiring retreatment, mostly cholecystectomy.

Conclusion: The probability of gallbladder stone recurrence after successful ESWL remains high during a decade of follow-up. Many patients require repeated nonsurgical treatment or cholecystectomy. Thus long-term results are unsatisfactory and ESWL should be offered only exceptionally.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Chi-Square Distribution
  • Cholelithiasis / diagnostic imaging
  • Cholelithiasis / therapy*
  • Confidence Intervals
  • Female
  • Follow-Up Studies
  • Humans
  • Lithotripsy / methods*
  • Male
  • Middle Aged
  • Pain Measurement
  • Probability
  • Recurrence
  • Retrospective Studies
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome
  • Ultrasonography