Shock wave lithotripsy: Incorrect

The objective of shock wave lithotripsy is to decrease the size of a stone to less than .5mm (in order for oral dissolution therapy to work). This treatment is always used in conjunction with oral dissolution therapy. Ideally the patient should have one stone that is less than two cm in size. This therapy becomes ineffective if there are more than 3 stones present. In properly selected patients, complete elimination of the stones is achieved in 25% within nine months. This treatment is generally reserved for patients with chronic cholecystitis and is not useful in the acute setting. This treatment is not FDA approved in the United States.

Mrs. Jones has an episode of acute cholecystitis. She is also in good general health and would not be at increased risk to undergo surgery. Shock wave lithotripsy is not the definitive treatment for cholecystitis because of the high chance of recurrence. This treatment would be considered as an option if her comorbidities made her a high surgical risk.

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