<原著>日本における体外衝撃波結石破砕装置 (ESWL) を用いた胆石治療の現状 : 全国アンケート調査より

To assess the current status of extracorporeal shock wave lithotripsy (ESWL) for the treatment of gall-stones in Japan, we conducted a nationwide survey by sending a questionnaire to 251 institutions using this therapy. Replies were obtained from 50 institutions. The use ofESWL was investigated over the period from its introduction up to October 1992. ESWL was performed on 2, 760 of 10, 058 patients with gallstones (27. 4%). The stones were completely pulverized in 1, 021 of these 2, 760 patients (37. 0%). Complete disappearance was limited to single gallstones less than 20 mm in maximum diameter. A comparison in the number of ESWL sessions revealed no significant difference between the patients with and without a good response. Choledocholithiasis was resolved completely in 44. 0% of 157 patients who underwent ESWL for this condition and intrahepatic stones were cured in 18. 7% of 32 patients. Therefore, ESWL may be a useful form of conservative therapy for biliary calculi.
体外衝撃波結石破砕装置(ESWL)を用いた胆石治療の実態を把握するために, ESWL の設置された全国251施設を対象としたアンケート調査を行い, 50施設から回答を得た. 調査期聞は各施設の ESWL 導入時から1992年10月までで, 各施設の10, 058例の胆嚢結石に対し, ESWL 治療は27. 4% に行われた. その治療効果は ESWL 施行2, 760例中, 完全消失が1, 021例37. 0% もあり, 完全消失例を得るための必要条件は, 個数は1個で, 最大径は20 mm 以下であることが判明した. 肝内・総胆管結石に対する ESWL 治療では, 総胆管結石は157例中44. 0% が消失, 肝内結石32例に対しても18. 7% が完全消失し, 今後の保存的治療法の一つとして期待される.