Interventional Radiology-Operated Endoscopy: Indications, Implementation, and Innovation

Interventional radiology‐operated percutaneous cholecystoscopy with ultrasonic lithotripsy and stone basket retrieval: A treatment for symptomatic cholelithiasis in non‐operative candidates

“…Due to an ageing population with multiple co‐morbidities, there is increasing demand for non‐surgical alternatives to treat symptomatic gallstone disease in poor surgical candidates . PC, while effective as a temporizing measure to relieve obstruction, results in definitive cholecystectomy in only one‐third of cases, as many patients remain ineligible .…”

“…Herein, we have presented our step‐wise approach to percutaneous cholecystoscopy and ultrasonic lithotripsy using a variation of recently reported techniques. It should be noted that while it is ideal to perform cholecystostomy and cholecystoscopy as a staged procedure, both may be performed as a single‐session in select cases . There is, however, a greater theoretical risk of haemorrhage and intraperitoneal bile leak if the access tract is not allowed to mature for at least 3 weeks .…”

“…There is, however, a greater theoretical risk of haemorrhage and intraperitoneal bile leak if the access tract is not allowed to mature for at least 3 weeks . Additionally, although many patients undergo general anaesthesia to reduce risks from large‐volume saline infusion during endoscopy, moderate conscious sedation with local analgesia is a viable alternative when general anaesthesia is contraindicated . Lastly, it is important to note that while cholecystoscopic removal of gallstones historically carries a 2.5–40% risk of recurrent cholelithiasis and/or cholecystitis, the addition of ursodeoxycholic acid 300 mg twice daily for at least 6 months postoperatively can be used as an adjuvant to prevent gallstone reformation …”

“…The incidence of gallstones is approximately 1 in 200 persons annually, of which 1–4% results in symptomatic cystic duct obstruction . For decades, surgical cholecystectomy has been the first‐line treatment for symptomatic cholelithiasis .…”

“…The incidence of gallstones is approximately 1 in 200 persons annually, of which 1-4% results in symptomatic cystic duct obstruction. [1][2][3] For decades, surgical cholecystectomy has been the first-line treatment for symptomatic cholelithiasis. 1,[4][5][6] With an ageing patient population having multiple medical co-morbidities, the role for percutaneous cholecystostomy (PC) drainage has continued to evolve, and has become the standard of care in patients with contraindications to surgery.…”