Efficacy and Safety of Endoscopic Laser Lithotripsy and Lithotomy through the Lumen-apposing Metal Stent for Giant gallbladder Stones

Overview

Journal VideoGIE

Specialty Gastroenterology

Date 2020 Jul 10

PMID 32642623

Citations 7

Authors

Wei Wang

Bowei Liu

Ke Qi

Xingang Shi

Zhendong Jin

Zhaoshen Li

Affiliations

Soon will be listed here.

Abstract

Background And Aims: EUS-guided gallbladder drainage has been increasingly applied for acute cholecystitis in high-risk surgical patients. In cases of EUS-guided gallbladder drainage with lumen-apposing metal stents (LAMSs), endoscopic retrieval of gallstones becomes feasible. However, retrieval of giant gallstones is still difficult because of the limited space in the saddle section of the LAMS. In this study, we aimed to evaluate the efficacy and safety of endoscopic laser lithotripsy and lithotomy through LAMSs for the removal of giant gallstones.

Methods: Five consecutive patients with recurrent cholecystitis due to giant gallstones were enrolled. We proceeded with EUS-guided LAMS implantation. Endoscopic laser lithotripsy and lithotomy then was performed through the LAMSs, and the stents were removed after all stones were extracted. The patients were followed up at scheduled times.

Results: EUS-guided LAMS implantation was successfully performed, and target gallstones were completely removed in all 5 patients. There was no severe bleeding, perforation, or stent migration during the operation. No recurrence of gallstones was found at late follow-up.

Conclusions: Endoscopic laser lithotripsy and lithotomy through LAMSs could be a safe and effective approach for removal of giant gallstones.

Citing Articles

Practical approach to linear endoscopic ultrasound examination of the gallbladder.

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PMID: 38983839 PMC: 11229944. DOI: 10.4329/wjr.v16.i6.184.

A Review on Endoscopic Management of Acute Cholecystitis: Endoscopic Ultrasound-Guided Gallbladder Drainage and Endoscopic Transpapillary Gallbladder Drainage.

Manudhane A, Leupold M, Shah H, Shah R, Han S, Lee P Medicina (Kaunas). 2024; 60(2).

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Endoscopic treatment of a giant stone in a patient with acute cholecystitis at a high surgical risk: breaking the paradigm (with videos).

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PMID: 36238806 PMC: 9551617. DOI: 10.1016/j.vgie.2022.07.007.

Current landscape of therapeutic EUS: Changing paradigms in gastroenterology practice.

Vanella G, Bronswijk M, Arcidiacono P, Larghi A, van Wanrooij R, de Boer Y Endosc Ultrasound. 2022; 12(1):16-28.

PMID: 36124531 PMC: 10134933. DOI: 10.4103/EUS-D-21-00177.

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