Gallstone recurrence after successful lithotripsy

We report the recurrence rate of gallstone within 5 years after successful lithotripsy. One hundred and fifty consecutive patients (solitary stones, 102 patients; multiple stones, 48 patients) were followed up for a median of 42 months (range 6–72) after stone clearance and cessation of bile acid therapy. No patient received any therapy to prevent recurrence. Thirty-seven patients developed recurrent gallstones. Probabilities of recurrence were (mean±SD) 6.6%±2%, 15.7%±3%, 22.8%±3.6%, 29.7+-4.5%, 32.2%±5% at 1, 2, 3, 4 and 5 years, respectively. The recurrence rate was lower in patients who had solitary stones than in patients with multiple stones (26.1% versus 47% at 5 years, respectively; p<0.009 - log rank test). Only five patients developed recurrent symptoms or stone complication (14%). We conclude that the recurrence rate after successful lithotripsy is lower than expected from dissolution studies, due to a low recurrence rate in patients who had solitary stones.