Laparoscopic One-Stage vs Endoscopic Plus Laparoscopic Management of Common Bile Duct Stones – A Prospective Randomized Study

Improvements in diagnostic and operative approach to CBD stones associated with cholelithiasis allow the surgeon to treat in a single stage the disease through a laparoscopic approach, The AA report the results of a prospective randomised study comparing this approach to a a double stage endoscopic plus laparoscopic cholecistectomy in 124 patients. techniques and procedures are referred and the results are statistically analysed. the outcome of the two procedures were recorded as success or failure according to the complete clearance of the CB

Stone recurrence after lithotripsy in patients with recurrent idiopathic calcium urolithiasis: Efficacy of treatment with Fiuggi water

A multicentric study was carried out on 384 patients (231 males, mean age 28.3 years; 153 females, mean age 40.8 years) previously treated with extracorporeal shock wave lithotripsy for recurrent idiopathic calcium urolithiasis. Patients were selected and submitted to different types of high fluid intake treatment (oligomineral water with a calcium content of 15 mg/l vs. tap water with a calcium content ranging between 55 and 130 mg/l) to evaluate stone recurrence and to identify any potential risk factors. During follow-up (range 14-34 months, mean 19 months) 44 (23%) of the 192 patients treated with tap water presented recurrence versus 32 (17%) of the 192 patients treated with Fiuggi mineral water, the difference in incidence between the two groups being 6%. Of the possible predictors of recurrence, evaluated at the beginning of follow-up and analyzed in a multivariate statistical study, the 24-hour diuresis and calciuria were seen to be directly related to the recurrence. copyright (C) 2000 S. Karger AG, Basel

The role of some risk factors in the prediction of stone recurrence after lithotripsy

The incidence of kidney stone recurrence after extracorporeal shock waves lithotripsy (ESWL) has to be re-valuated and the identification of potential risk factors, able to predict the recurrence, is under discussion. This prospective study, carried out on a homogeneous group of 520 patients (275 males, 245 females; aged 14-79 years), previously treated with ESWL for idiopathic calcium nephrolithiasis, allowed to estimate the incidence of recurrence (101 relapses; mean incidence of about 10% per year) with a long enough follow-up (23 months on average; median =24 months, range = 12-48 months). Multivariate statistical analysis performed to predict the recurrence by some possible risk factors, showed that age was inversely related to occurrence of the event (Relative Risk (RR) =0.9837; 95% CL=0.9689-0.9987) whereas urinary calcium (UC) (RR=1.0013; 95% CL=1.0003- 1.0022), alkaline phosphatase (AP), (RR=1.0048; 95% CL=1.0021-1.0074) and history of previous relapses (RR=1.5239; 95% CL=1.0226-2.2710) were directly related to the recurrence. The levels of UC were not correlated to those of AP (linear correlation coefficient r=0.0032), but the combination of their high levels increased the risk of recurrences