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

Abstract

Interventional radiology‐operated percutaneous endoscopy has seen a recent resurgence with potential to return to the scope of Interventional Radiology practice. Endoscopy adds a new dimension to the Interventional Radiology armamentarium by offering a unique opportunity to diagnose and treat conditions under direct visualization with improved maneuverability. Cholecystoscopy (gallbladder endoscopy), as a method for percutaneous removal of gallstones, is an effective treatment option in patients with symptomatic cholelithiasis who are poor candidates for surgical cholecystectomy. This article presents a case of Interventional Radiology‐operated cholecystoscopy using ultrasonic lithotripsy and stone basket retrieval with an emphasis on the equipment, technique, and peri‐procedural management essential to the procedure, as well as a review of the literature.

Percutaneous Interventions for Symptomatic Cholelithiasis and Acute Cholecystitis

“…This technique was also successfully demonstrated in a 2019 case report. 23 The most recent paper evaluating cholecystoscope-guided PCCL using similar techniques was published in 2021, consisting of 75 patients and demonstrated complete gallstone removal in 91% with 23% experiencing a post-procedural gallstone related complication and 5% recurrence rate. 24 This further establishes this approach as a potentially definitive option in non-surgical patients.…”

The evolution of interventional radiology literature in Australia and New Zealand

“…In addition, interventional topics have been increasing over the last 5 years. We have seen topics of safe IR‐led sedation, 4,5 diagnostic and technical experiences through all body systems 6‐21 and have been shown that IR offers low‐cost alternatives to traditional surgical procedures 22‐24 …”