Lithroscopy also referred to as lithotripsy, or EWSL (Extracorporeal Shock Wave Lithotripsy) as is a technique using ultrasonic sound waves to blast the hard crystals of kidney stones into smaller particles which can then be flushed from the body. The ultrasound is applied outside the body and surgery is not required.
Although lithotripsy would seem like a great idea for gallstones, the stones don’t really respond to sound waves. Gallstones usually comprise cholesterol and bile salts, too soft to be blasted by lithroscopy, the shock waves are more easily absorbed.
Gallstones are usually larger than kidney stones by the time they are noticed, and the larger stones don’t respond well to lithroscopy either.
Also making a less suitable treatment is that the gallbladder only contracts after meals, so most of the time it lies dormant. When it does contract, only a small amount of bile is flushed into the small intestine. In comparison, the kidneys produce far more and are constantly flushing at least a small amount.
One of the dangers of incomplete blasting of stones is that one of the larger pieces may become lodged in the main bile duct and and cause a build up of pressure in the gallbladder. When severe, jaundice with dark urine and a fever indicate an infection of the bile duct (cholangitis). This condition is managed by removing the stones from the bileduct.
This is an inflammation of the pancreas . Small gallstones that have escaped from the gallbladder into the bile duct can pass the pancreas (a digestive organ at the back of the abdomen ) and cause it to become inflamed.
Pancreatitis can range from a minor pain through to a severe life threatening illness. The gallbladder is usually removed as soon as possible after a bout of pancreatitis, so that there is little chance of a further attack.
Removal of the gallbladder usually does not cause many problems. Bile is used to help digest fat in foods. Even when the gallbladder is removed the liver continues to make bile which drains into the intestine. The gallbladder is a storage container for bile so that extra is available during food digestion.
Because this reservoir of bile is gone, some patients may have mild diarrhea after the gallbladder is removed, while others will have no symptoms. In general patients may eat normally and only make changes to the diet if necessary.
There are a number of options to help with stone passage, but shock-wave lithotripsy is the most common technique suggested. This involves immersing the patient in a bath of water and aiming sound waves at the stone to break it up.
A shift away from shock-wave lithotripsy (SWL) and toward flexible ureteroscopy is changing the landscape of stone disease treatment, said Mihir M. Desai, MD, during the Cleveland Clinic’s Nephrology Update.
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So Monday I got to undergo a lithotripsy . Since it is extremely painful I was put under general anesthesia, so I don’t remember a thing. Basically,they use sound waves to pulverize the stone so it can be passed.