EVALUATION OF HEPATOCYTE FUNCTION AFTER EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY WITH HEPATOBILIARY SCINTIGRAPHY

Objective: Extra corporeal shock wave lithotripsy is a promising and e ffective therapy mode in the nonsurgical therapy of gallstones. This p rospective study was conducted to investigate the effects of ESWL on h epatocellular function, using quantitative hepatobiliary scintigraphy, serum aminotransferase, alkaline phosphatase (ALP), amylase (AML), an d direct and indirect bilirubin levels. Methods: The study consisted o f 22 patients with ultrasonographically documented gallstones. Hepatob iliary scintigraphy was applied to all patients before ESWL and bioche mical tests were performed. Scintigraphy and biochemical tests were re peated in 16 patients 24 h, in seven patients 72 h, and in six patient s 1 wk after ESWL. The hepatic extraction fraction (HEF) was calculate d using deconvolution analysis of scintigraphic data. Results: All pat ients' pre-ESWL biochemical tests and HEF values were within the norma l range. The 24- and 72-h post-ESWL aminotransferase, ALP, and AML lev els and HEF values were significantly different from pre-ESWL values ( p < 0.05). After 1 wk this difference disappeared. Decreased HEF value s were observed in 50% of patients 24 h, in 71.7% of patients 72 h, an d in 16.6% of patients 1 wk after ESWL. A direct relationship was also observed between the number of shocks applied and the degree of impai rment in HEF values. Conclusion: Transient hepatocellular dysfunction, which usually occurs after ESWL, can be demonstrated and monitored us ing quantitative hepatobiliary scintigraphy. (Am J Gastroenterol 1998; 93:1905-1908. (C) 1998 by Am. Coll. of Gastroenterology)