{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T15:45:46Z","timestamp":1765640746374,"version":"3.48.0"},"reference-count":22,"publisher":"BMJ","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1994,6]]},"abstract":"<jats:p>The symptoms of 100 patients with gall bladder stone disease were prospectively analysed before and after successful treatment with extracorporeal shock wave lithotripsy (ESWL) and oral bile acids. This is of considerable clinical interest because complaints after cholecystectomy persist in 21-47% of patients (postcholecystectomy syndrome). Before ESWL, 37 patients had unspecific abdominal symptoms (feeling of fullness and pressure, or slight pain, or both, in the right upper abdomen, flatulence, nausea, or food intolerance) and 63 patients had typical biliary symptoms (severe steady pain of more than 15 minutes and less than five hours duration in the right upper abdomen, in some cases radiating to the epigastrium or the back) either exclusively or with unspecific abdominal complaints. After becoming stone free, 72 of 100 patients lost the symptoms they had before treatment. All 28 patients with persisting symptoms had unspecific abdominal symptoms before treatment (exclusively unspecific symptoms and unspecific plus typical biliary symptoms). In contrast, patients with typical biliary symptoms before ESWL lost these in 95% of all cases. Although the anatomical structures are left intact after ESWL, the percentages of stone free patients with persisting symptoms are similar to those after cholecystectomy.<\/jats:p>","DOI":"10.1136\/gut.35.6.819","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"819-821","source":"Crossref","is-referenced-by-count":1,"title":["Relief of heterogeneous symptoms after successful gall bladder stone lithotripsy and complete stone disappearance."],"prefix":"10.1136","volume":"35","author":[{"given":"U","family":"St\u00f6lzel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Koszka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B","family":"W\u00f6lfer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"U","family":"Kleine","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W","family":"Pommerien","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E O","family":"Riecken","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1994,6,1]]},"reference":[{"key":"ref_1","unstructured":"On average (mean (SD)) 2463 (1440) shock waves (median 1782; range, 657-9100) were directed under continuous sonographic control to the stone(s) positioned in the focus. Nine patients were treated by one to two sessions (median 1; mean 15 (0 5)) with a Lithostar Ultra lithotriptor (Siemens) using (mean (SD)) 3940 (2615) shock waves (median 3067; range 900-9100). Before each session, 95 patients were given 40 mg promethacine by mouth plus 7 5-15 mg piritramide intraveneously or 50 mg pethidine plus 2 5-5 mg midazolam intraveneously for analgesia. All patients received adjuvant oral litholytic treatment with ursodeoxycholic acid and chenodeoxycholic acid each 7 5 mg\/kg of body weight per day until two months after the gall bladder was stone free.","article-title":"On average (mean (SD)) 2463 (1440) shock waves (median 1782; range, 657-9100) were directed under continuous sonographic control to the stone(s) positioned in the focus. Nine patients were treated by one to two sessions (median 1; mean 15 (0 5)) with a Lithostar Ultra lithotriptor (Siemens) using (mean (SD)) 3940 (2615) shock waves (median 3067; range 900-9100). Before each session, 95 patients were given 40 mg promethacine by mouth plus 7 5-15 mg piritramide intraveneously or 50 mg pethidine plus 2 5-5 mg midazolam intraveneously for analgesia. All patients received adjuvant oral litholytic treatment with ursodeoxycholic acid and chenodeoxycholic acid each 7 5 mg\/kg of body weight per day until two months after the gall bladder was stone free"},{"key":"ref_2","first-page":"723","article-title":"Computer analysis of postcholecystectomy biliary tract symptoms","volume":"124","author":"Bodvall, V.; Overgard, B.","year":"1967","unstructured":"Bodvall V, Overgard B. Computer analysis of postcholecystectomy biliary tract symptoms. Surg Gynecol Obstet 1967; 124: 723-32.","journal-title":"Surg Gynecol Obstet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/S0140-6736(72)91683-2","article-title":"Some clinical observations on patients with gallstones","volume":"ii:","author":"Gunn, A.; Keddie, N.","year":"1972","unstructured":"Gunn A, Keddie N. Some clinical observations on patients with gallstones. Lancet 1972; ii: 239-41.","journal-title":"Lancet"},{"key":"ref_4","first-page":"487","article-title":"Post surgical syndromes: the biliary tract","volume":"8","author":"Tondelli, P.; Gyr, K.; Stalder, G.A.; Allgower, M.","year":"1974","unstructured":"Tondelli P, Gyr K, Stalder GA, Allgower M. Post surgical syndromes: the biliary tract. Clin Gastroenterol 1974; 8: 487-504.","journal-title":"Clin Gastroenterol"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1136\/gut.28.11.1500","article-title":"Postcholecystectomy symptoms. A prospective study of gall stone patients before and two years after surgery","volume":"28","author":"Ros, E.; Zambon, D.","year":"1987","unstructured":"Ros E, Zambon D. Postcholecystectomy symptoms. A prospective study of gall stone patients before and two years after surgery. Gut 1987; 28: 1500-4.","journal-title":"Gut"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/S0140-6736(88)91405-5","article-title":"Satisfaction after cholecystectomy","volume":"i:","author":"Rhodes, M.; Lennard, T.W.","year":"1988","unstructured":"Rhodes M, Lennard TW. Satisfaction after cholecystectomy. Lancet. 1988; i: 599.","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1002\/bjs.1800780823","article-title":"Influence of cholecystectomy on symptoms","volume":"78","author":"Bates, T.; Ebbs, SR, Harrison; M, A.'Hern; R.P.","year":"1991","unstructured":"Bates T, Ebbs SR, Harrison M, A'Hern RP. Influence of cholecystectomy on symptoms. BrJ Surg 1991; 78: 964-7.","journal-title":"BrJ Surg"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"124","DOI":"10.3109\/00365529108996493","article-title":"Persisting pain after cholecystectomy","volume":"26","author":"Jorgensen, T.; Teglbjerg, J.S.; Wille-Jorgenson, P.; Bille, T.; Thorvaldsen, P.","year":"1991","unstructured":"Jorgensen T, Teglbjerg JS, Wille-Jorgenson P, Bille T, Thorvaldsen P. Persisting pain after cholecystectomy. Scand J Gastroenterol 1991; 26: 124-8.","journal-title":"Scand J Gastroenterol"},{"key":"ref_9","first-page":"818","article-title":"Fragmentation of gallstones by extracorporeal shock waves","volume":"318","author":"true","year":"1986","unstructured":"Sauerbruch T, Delius M, Paumgartner G, Holl J, Wess 0, Weber W, et al. Fragmentation of gallstones by extracorporeal shock waves. N Engli Med 1986; 318: 818-22.","journal-title":"N Engli Med"},{"key":"ref_10","first-page":"1239","article-title":"The effect of ursodiol on the efficacy and safety ofextracorporal shock-wave lithotripsy of gallstones","volume":"323","author":"Li, Schoenfield; G, Berci; RL, Carnovale; W, Casarella; P, Caslowitz; D, Chumley","year":"1990","unstructured":"Schoenfield Li, Berci G, Carnovale RL, Casarella W, Caslowitz P, Chumley D, et al. The effect of ursodiol on the efficacy and safety ofextracorporal shock-wave lithotripsy of gallstones. The Dornier National Biliary Lithotripsy Study. NEnglJ Med 1990; 323: 1239-45.","journal-title":"The Dornier National Biliary Lithotripsy Study. 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Hepatology 1989; 9: 856-60.","journal-title":"Hepatology"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.35.6.819","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T15:41:41Z","timestamp":1765640501000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.35.6.819"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1994,6]]},"references-count":22,"journal-issue":{"issue":"6","published-online":{"date-parts":[[1994,6,1]]},"published-print":{"date-parts":[[1994,6]]}},"alternative-id":["10.1136\/gut.35.6.819"],"URL":"https:\/\/doi.org\/10.1136\/gut.35.6.819","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"type":"print","value":"0017-5749"},{"type":"electronic","value":"1468-3288"}],"subject":[],"published":{"date-parts":[[1994,6]]}}}