Wandel und akzeptanz operativer und nichtinvasiver therapieverfahren bei cholezystolithiasis

Translated title of the contribution: Change and acceptance of surgical and non-invasive management of gallblader stones

H. Thomas Schneider*, Ekkehard Schell, Franc Wenzel, Johannes Benninger, Thomas Rabenstein, Hendrik Flügel, Alexander Katalinic, Eckhart G. Hahn, Christian Ell

*Corresponding author for this work
3 Citations (Scopus)


Background: The treatment of cholecystolithiasis has changed fundamentally in recent years due to the development of non-surgical techniques (extracorporeal shockwave lithotripsy [ESWL], oral litholysis) and the implementation of laparoscopic cholecystectomy. Patients and Results: Retrospective analysis of 2,270 patients (1,649 women, 621 men; age 47.2 ± 14 years) presenting with gallstone disorders in a university medical outpatients department between 1988 and 1992 in order to be instructed as to the most suitable therapy method bear witness to the rapid change in therapeutic procedure. Laparoscopic removal of the gallbladder has virtually supplanted conventional cholecystectomy, and within 5 years the proportionate role of ESWL has declined from 21 to 12%. Over the years, the proportion of patients requiring no therapeutic intervention remained constant (at about 20%). The therapeutic recommendations of the 'experts' were implemented in almost 80% of cases. The majority of patients were satisfied with the chosen therapeutic approach (surgery: 93.0%, ESWL: 77.6%), although 44% of ESWL-patients and 36% of surgically managed patients reported complaints which persisted even after completion of therapy. Despite unsuccessful ESWL (residual fragments or recurrent stones) 58/95 (61%) of interviewed patients would again give preference to this noninvasive modality in the event of a renewed therapeutic decision. Conclusion: Only a few years after its introduction, laparoscopic cholecystectomy has asserted itself as the predominant treatment option. But as far as acceptance and preference by the patient are concerned extracorporeal shockwave lithotripsy - as a non-invasive treatment modality - also enjoys high popularity and can be recommended as an alternative to surgery in suitable patients chosen according to the currently established stringent selection criteria.

Translated title of the contributionChange and acceptance of surgical and non-invasive management of gallblader stones
Original languageGerman
JournalMedizinische Klinik
Issue number8
Pages (from-to)457-462
Number of pages6
Publication statusPublished - 15.08.1998


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