Lithotripsy

Staff writer Edwin Chen’s article (Part A, Feb. 28) on the runaway costs of medical technology incorrectly implies that the expensive lithotripter machines are successful for only 10% to 25% of patients with gallstones, and that the treatment caused disturbing side effects such as blood in the urine and high blood pressure. For patients with one or two stones, European studies have shown a success rate of nearly 90%, but only 15% to 20% of patients suffering from this disease have this number of stones.

Here at UC Irvine, and at other research institutions, investigators are combining lithotripsy with other less expensive nonsurgical techniques so that patients not currently candidates for lithotripsy could undergo the procedure and still avoid the cost of hospitalization and surgery. That bloody urine and hypertension can occur is true, but these have been described for patients having kidney stone lithotripsy. With gallstone lithotripsy, the energy is directed away from the kidneys, so these complications should occur with much less frequency. These distinctions somehow were absent from Chen’s article, but are important to know when assessing the efficacy and safety of these new devices.

JEFFREY C. BRANDON, MD

Assistant Professor of

Radiological Sciences

Chief of Lithotripsy

UC Irvine