Percutaneous Rotational Lithotripsy of Gallbladder Stones

Abstract

Ten patients (aged 39-94 years) with cholecystolithiasis were selected for percutaneous rotational lithotripsy with the Rotolith lithotriptor either because they were considered high-risk patients for cholecystectomy or because they had refused surgery. The procedure was completed in 7 patients. Five of these were stone-free at cholangiography I to 2 days after lithotripsy. Conclusive cholangiograms were not obtained in 2 patients due to gallbladder leakage, which in itself did not cause any serious sequelae. At ultrasonography after one month, one of these 2 patients had no visible gallbladder, the other one had small residual gallbladder stones. Rotational lithotripsy is an alternative to cholecystectomy in patients at high surgical risk, especially elderly patients who have undergone cholecystostomy as an emergency treatment for acute cholecystitis.

Gallbladder Drainage: IR and GI Perspective

“…Mechanical and ultrasonic stone destruction have been previously attempted in the 1980s and 1990s, 29,30 but likely due to the maturation of laparoscopic cholecystectomy methods their excitement waned. It may be that direct visualization through disposable endoscopes is what the field needs to reignite interest in these technologies.…”