Effects of extracorporeal shock wave lithotripsy on Na+-K+-ATPase activityin hepatocyte plasmalemma of rabbits

Extracorporeal shock wave lithotripsy (ESWL) is generally considered as an effective cure for cholelithiasis. The present study is to explore whether ESWL does damage to hepatocytes. After the liver area was exposed to a give n period of extracorporeal shock wave (ESW), the livers of 14 rabbits were taken out and samples for electron microscopy were prepared. The Na+-K+-ATP ase activity in hepatocytes and the extent of damage by ESW was quantified by the cytochemical method using cerium (Ce) as the capture and by the elec tron probe X-ray microanalysis. It was observed that the Na+-K+-ATPase reac tion products containing Ce were located on the sinusoidal, lateral and bil e canalicular membrane, and were most concentrated on the latter one. The p eak and background ratio (P/B) of Ce on the canalicular membrane in the con trol samples was 1.18 +/- 0.36; and in the samples exposed to ESW for 15, 3 0, 45 min, was 0.88+/-0.26, 0.86+/-0.22 and 0.48+/-0.31 respectively. The d ifferences between the control and ESW-treated samples were statistically s ignificant (p<0.01). However, the P/B of Ce in the samples of 60(th) day af ter 30 min ESW exposure was 1.04+/-0.26. No difference existed as compared with the control (P>0.05). In addition, the Ce content of the reaction prod ucts on the canalicular membrane decreased to about 1/3 by ouabain treatmen t, indicating that rich Na+-K+-ATPase activity exists. These findings indic ate that the ESWL performed on cholelithiasis may exert certain harmful eff ects on adjacent hepatocytes. Fortunately, the effects disappear within two months.