Konservative Therapie der Cholezystolithiasis

Publisher： Karger

E-ISSN： 2297-475x|17|2|123-131

ISSN： 2297-4725

Source： Visceral Medicine (formerly: Viszeralmedizin), Vol.17, Iss.2, 2001-07, pp. : 123-131

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Abstract

Non-Surgical Treatment of Gallbladder Stones With rare exceptions, treatment is recommended only in the symptomatic stage of gallstone disease. Normal gallbladder ejection function and absence of cholecystitis are prerequisites for non-surgical therapy. In oral bile acid dissolution therapy, ursodeoxycholic acid is administered. Suitable patients have stones not larger than 5–10 mm. Complete stone dissolution can be expected in 40–70% of the patients within 1–2 years of treatment. Patients with single, radiolucent stones 20 mm or less in diameter are suitable for extracorporeal shock-wave lithotripsy. In general, this method is combined with adjuvant bile acid dissolution therapy. Complete disappearance of all fragments can be expected in 60–90% of the patients within 3–12 months. Gallstone recurrence has to be expected in 30–50% of the patients. Recurrence is less frequent in patients showing good gallbladder contraction than in patients with impaired gallbladder emptying. In selected patients with gallbladder calculi, non-surgical therapy is a safe and effective alternative to cholecystectomy.