The nonsurgical management of gallstone disease has drawn widespread clinical interest during the last decade as ultrasound surveys have indicated that cholelithiasis is predom inantly an asymptomatic condition and much more prevalent than previously thought. This book presents an overview of the pathophysiologic and pathobiochemical principles of gallstone formation and the consequences for clinical therapeutic regimens. New information concerning the balance between vesicular and micellar transport of choles terol, early cholesterol nucleation, and the influence of inhibiting and promoting com pounds for cholesterol nucleation as well as information concerning the effects of changes in gallbladder motility and gallbladder mucosal function is reviewed. In order to make further progress in developing treatments which facilitate gallstone dissolution and in preventing disease, it is necessary to integrate this new data into our thinking. Methods of treatment such as systemic litholysis of cholesterol gallbladder stones with bile acid preparations and mechanical fragmentation of stones either by extracorpo ral shock waves or intracorporal laser systems are carefully described and separate discussions of direct contact litholysis of cholesterol stones with ether preparations and the local litholytic treatment of calcified pigment stones are included. New therapeutic applications of HMG-CoA-reductase inhibitors and nonsteroidal anti-inflammatory drugs are also critically reviewed. Finally, for the interested reader an evaluation of prophylactic treatment against stone recurrence after successful conservative treatment and an appraisal of alternative management strategies supplement the information on the conservative treatment of gallstones.

Ein grosser Teil der empfangenen Ultraschallinformation geht bei der Erstellung des Ultraschallbildes am Bildschirm verloren. Im vorliegenden Buch werden Techniken vorgestellt, die diese bislang nicht genutzten Informationen verwerten. Im Mittelpunkt stehen die Ultraschallhochfrequenzanalyse und die dreidimensionale Darstellung von Ultraschallbildern. Aber auch Anwendungen wie die Duplexsonographie und die Angiodynographie sowie die elektronische Befunddokumentation werden behandelt. Das Buch gibt damit eine Fulle von Anregungen fur die Weiterentwicklung der Bildverarbeitung in der Ultraschalldiagnostik.