Lithotripsy for gallstones was once thought to be a treatment that
showed great promise. It is seldom used anymore; it is effective in
only a small percentage of patients, and the stones usually return.
Attacks of painful biliary colic are common after this procedure.
This may be of interest to you:
"Shock wave lithotripsy, a noninvasive procedure that FDA approved for
treating kidney stones in 1985, seemed to hold great promise for
treating gallstones as well. (To treat kidney stones, the torso of the
anesthetized but conscious patient is immobilized and lowered into a
large tub of water, where x-rays are used to locate the stone and
position the patient properly. In a procedure lasting one to two
hours, the kidney stones are then crushed, without harming bone or
soft tissue, by repeated shock waves from a generator at the bottom of
the tub.)
'At the outset we thought, gee, it'll be great for gallstones, too.
But gallstones turned out to be a whole different animal,' says FDA's
Mark Kramer, chief of the office of device evaluation's
gastroenterology/urology branch I.
Not only are gallbladder stones chemically different from kidney
stones, but kidney stones are easier to pass once shattered because
urine forms in the kidney and collects in the bladder all the time. In
contrast, the gallbladder squirts only intermittently, and may not
contract and expand enough in patients who form stones for the stones
to be passed. As a result, gallstone dissolution drugs usually must be
taken along with the lithotripsy treatment. Based on the clinical data
available, lithotripsy for gallstones may only work for 10 to 15
percent of sufferers, Kramer says, and it is not yet known which types
of patients would benefit more from it than from drugs or surgery."
http://www.fda.gov/bbs/topics/CONSUMER/CON00010.html |
