Good Vibrations: Successful Endoscopic Electrohydraulic Lithotripsy for Bouveret’s Syndrome

Sethi, Saurabh; Kochar, Rajan; Kothari, Shivangi; Thosani, Nirav; Banerjee, Subhas

doi:10.1007/s10620-014-3424-8

Cited by 10 publications

(6 citation statements)

References 8 publications

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“…It is not as expensive as laser lithotripsy and may be more readily available in smaller hospitals. In a case reported by Sethi et al, 40 a double-channel therapeutic gastroscope was used for to allow for continuous irrigation. The authors report fragmenting the stone first using EHL with water immersion.…”

Section: Discussionmentioning

confidence: 99%

Bouveret syndrome: current management strategies

Caldwell

Lee

Leggett

et al. 2018

CEG

103

105

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Bouveret syndrome is a rare complication of cholelithiasis that usually presents with signs and symptoms of gastric outlet obstruction. Given the relative rarity of this condition, there are no standardized guidelines for the management of this condition. In this paper, we review the diagnosis and management options (endoscopic, laparoscopic, and open approaches) of patients with Bouveret syndrome, including a report of one case to illustrate some of the endoscopic and surgical principles of management.

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Section: Discussionmentioning

confidence: 99%

Bouveret syndrome: current management strategies

Caldwell

Lee

Leggett

et al. 2018

CEG

103

105

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show abstract

“…Among other lithotripsy techniques, EHL is more readily available and less expensive than laser lithotripsy, as Sethi et al first described in a case report. 7 Unfortunately, EHL alone could not fragment the gallstone in our patient, because it was extremely hard. We then decided to split the stone using a combination of EHL and balloon expansion.…”

Section: Discussionmentioning

confidence: 76%

“…Among other lithotripsy techniques, EHL is more readily available and less expensive than laser lithotripsy, as Sethi et al. first described in a case report 7 …”

Section: Discussionmentioning

confidence: 99%

Endoscopic treatment of Bouveret syndrome with a combination of electrohydraulic lithotripsy and balloon expansion: A case report

et al. 2023

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Bouveret syndrome is a rare type of ileus caused by the impaction of gallstones passing through a cholecystoenteric fistula in the duodenum. Endoscopic treatment with minimally invasive procedures is preferable for patients with this syndrome, typically for elderly individuals with a high surgical risk. Conventional endoscopic techniques often fail to remove impacted stones that are generally large and occasionally solid. We report the case of an 88‐year‐old bedridden woman with severe dementia who presented with difficulty in breathing. The patient was diagnosed with aspiration pneumonia. In addition, computed tomography showed a cholecystoduodenal fistula and a gallstone 37 mm in diameter that impacted the duodenal bulb. Bouveret syndrome was diagnosed on the basis of the computed tomography findings. The impacted stone was too large and hard to split with standard endoscopic lithotripsy using grasping forceps, mechanical lithotripter, polypectomy snare, basket catheter, and electrohydraulic lithotripsy (EHL). However, EHL with a dual‐channel therapeutic endoscope was achieved to drill a narrow hole approximately 20 mm deep into the stone, in four sessions. The stone was subsequently split by inflating the balloon, which was inserted into the hole, to 10 mm in diameter at 3 atm. All the split stones were spontaneously excreted during defecation after a few days. If the gallstone is too hard to fragment by endoscopic EHL alone, a combination of EHL and balloon expansion might be a useful alternative.

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“…Common methods used to break the large stone into pieces include endoscopic lithotripsy, extracorporeal shock wave lithotripsy, electro-hydraulic lithotripsy, and endoscopic laser lithotripsy. The latter two technologies are simple, safe, and effective, with few complications, and are currently the most commonly used methods[10]. However, some scholars believe that endoscopic lithotomy increases the risk of esophageal injury, digestive tract perforation, and gastrointestinal bleeding.…”

Section: Discussionmentioning

confidence: 99%

Bouveret syndrome: A case report

Wang¹,

Du²,

Chen³

et al. 2019

WJCC

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BACKGROUNDBouveret syndrome is a rare complication of cholelithiasis, with only 315 cases reported in the literature between 1967 and 2016. Delay in diagnosis is associated with a high mortality rate. Diagnosis is based upon clinical manifestations, gastroscopy, and imaging studies such as abdominal computed tomography and magnetic resonance cholan-giopancreatography. Endoscopic stone extraction or lithotripsy is the preferred choice for treatment as it is safe and minimally invasive with few complications. However, if endoscopy fails, surgery is required.CASE SUMMARYA 61-year-old female patient presented with recurrent epigastric pain for more than 6 mo. On endoscopy, a large amount of food residue was present in the stomach with multiple stones and ulcers in the antro-pyloric region. Based on these findings, a diagnosis of gastrolithiasis was made. However, computed tomography of the abdomen revealed the correct diagnosis of Bouveret syndrome. Initially, endoscopic treatment was attempted but it failed. Later, she was successfully managed by cholecystectomy with duodenal stone extraction and fistula repair (one-step method). At the last follow-up 6 mo after surgery, the patient was symptom-free.CONCLUSIONBouveret syndrome is a rare complication of gallstones that requires prompt endoscopic or surgical treatment to prevent mortality.

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Good Vibrations: Successful Endoscopic Electrohydraulic Lithotripsy for Bouveret’s Syndrome

Cited by 10 publications

References 8 publications

Bouveret syndrome: current management strategies

Bouveret syndrome: current management strategies

Endoscopic treatment of Bouveret syndrome with a combination of electrohydraulic lithotripsy and balloon expansion: A case report

Bouveret syndrome: A case report

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