Piezoelectric biliary lithotripsy: an in vitro study of factors affecting gallstone fragmentation.

Piezoelectric biliary lithotripsy: an in vitro study of factors affecting gallstone fragmentation. Research Abstract Details 

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Piezoelectric biliary lithotripsy: an in vitro study of factors affecting gallstone fragmentation. Abstract Text:

S J Schulte,R L Baron,

Factors affecting the fragmentation of gallstones with piezoelectric lithotripsy were studied in vitro, with a goal of providing data that will help direct treatment with piezoelectric lithotriptors. Two hundred fifty-seven stones from 50 patients were treated with the EDAP LT.O1 lithotriptor until all fragments measured 2 mm or less in diameter. The fragmentation process was observed, and two patterns were evident: central fragmentation and peripheral chipping. The majority of stones fragmented centrally. Fragmentation characteristics in different stones from the same patient were compared with those from different patients. Stone diameter, shock-wave frequency and power, and CT appearance were examined and correlated with fragmentation. Gallstones from the same patient showed uniform fragmentation patterns and consistent relationships between fragmentation time and gallstone size, shock-wave frequency, and power. In stones from the same patient, gallstone size had a marked effect on fragmentation time, which correlated with the cube of the stone diameter, and shock-wave frequency and power had a proportional inverse linear relationship with fragmentation time. When controlling for stone size and treatment parameters, stones from multiple patients showed marked differences in fragmentation time, and because of this, poor correlation between stone size and fragmentation time. Stones grouped according to CT pattern and attenuation showed wide variation and no correlation between CT characteristics and fragmentation pattern or fragmentation time. Our results show that a great variability exists in fragmentation time of gallstones, making it impossible to accurately predict fragmentation time at a given stone size. Only rough estimates of longer fragmentation times with increasing stone size can be made. The linear relationships between shock-wave frequency or power and fragmentation time allow one to easily predict the effect of manipulating these variables and to tailor treatment to each patient's tolerance. Finally, CT appearance does not appear to be predictive of fragmentation outcome.

Piezoelectric biliary lithotripsy: an in vitro study of factors affecting gallstone fragmentation. Publishing Authors By Initials

SJ Schulte,RL Baron,

For similar therapeutics: lithotripsy research abstracts see: therapeutics: lithotripsy research

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Piezoelectric biliary lithotripsy: an in vitro study of factors affecting gallstone fragmentation. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: AJR. American journal of roentgenology

VOLUME: 155

Page Numbers: 1211-6

Journal Abbreviation:

ISSN: 0361-803X

DAY: 15

MONTH: Dec

YEAR: 1990

Piezoelectric biliary lithotripsy: an in vitro study of factors affecting gallstone fragmentation. Information

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LANGUAGE: eng

NlmUniqueID: 7708173

Piezoelectric biliary lithotripsy: an in vitro study of factors affecting gallstone fragmentation. Keywords Mesh Terms:

KEYWORDS: Lithotripsy

MESH TERMS: therapy

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Grant and Affiliation Information for Piezoelectric biliary lithotripsy: an in vitro study of factors affecting gallstone fragmentation.

AFFILIATION: Department of Radiology, University of Washington Medical Center, Seattle 98195.

Country: UNITED STATES

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MEDLINETA: AJR Am J Roentgenol

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