cqvip:Objective.The risk of recurrence has limited the acceptability of conservative therapies of gallbladder stones.The aim of the present study was to determine the long-term rate of stone recurrence and its risk factors after successful extracorporeal shock-wave lithotripsy(ESWL).Material and methods.The study comprised a prospective ultrasound follow-up at yearly intervals or whenever biliary pain was reported.A total of 192 consecutive patients(primary single stones,n = 159;primary 2 or 3 stones,n = 33)were followed for up to 11.2 years after becoming stone-free and after termination of adjuvant treatment with ursodeoxycholic acid(UDCA).Results.Eighty-four patients developed recurrent stones after a median of 2.6 years(maximum = 8.8 years).The 108 patients without recurrence were followed for a median of 6.7 years(maximum = 11.2 years).By actuarial analysis,the cumulative recurrence rates for these 192 stone-free patients were 27%±3%,41%±4%and 54%±4%(observed ±SE)at 3,5 and 10 years,respectively.Cox’s regression analysis was used to identify the presence of slight calcification in the primary stone(s)as a protective feature against recurrence(p = 0.03).Conclusions.1)The risk of recurrence continues to increase over time,and although it rises less steeply after 5 years,it does not reach a plateau until at least 10 years.2)Having had slightly calcified stone(s)seems to be associated with a reduced risk of recurrence and might signal a "burnt out" lithogenic process.3)The long-term results are unsatisfactory and ESWL of gallbladder stones should be offered only in special cases.
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