The ability of the acoustic energy/stone burden ratio to predict gallstone clearance in biliary lithotripsy.

P. O. Moon, D. E. Scheeres, K. Mills

Research output: Contribution to journalArticlepeer-review

Abstract

The relationship between acoustic energy, stone burden, and stone clearance in biliary extracorporeal shock wave therapy (ESWL) is unclear. We hypothesized that there is a consistent relationship between these parameters that enables gallstone clearance to be predicted. Using a porcine model and various gallstone burdens, we performed biliary ESWL with varying energy levels and number of shock waves. The acoustic energy/stone burden ratio (AE/SB) was calculated that incorporated these variables. Stone clearance increased with higher energy settings and fewer stones present (p less than 0.005). The relationship between AE/SB ratio and stone clearance was logarithmic (r 2 = 0.82). The plateau of this curve showed optimal stone clearance at approximately 20 joules/g, beyond which point the benefit of further ESWL may not outweigh the risks. This relationship between AE/SB ratio and stone clearance may be able to predict the optimal energy required and probable outcome of biliary ESWL prior to the procedure.

Original languageEnglish (US)
Pages (from-to)77-82
Number of pages6
JournalThe Journal of stone disease
Volume5
Issue number2
StatePublished - Apr 1993

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