Endoscopic lithotripsy of a gallstone impacted in lumen-apposing metal stent positioned for cholecysto-gastrostomy

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

“…At high volume institutions, patients routinely undergo cholecystoscopy one month following EUS-GBD for stone removal, LAMS removal, and placement of a double pigtail plastic stent [58]. Recent studies have emerged demonstrating that large stones can be removed through both endoscopic laser lithotripsy and lithotomy (ELLL) and electrohydraulic lithotripsy (EHL) [59,60]. In one study by Wang et al, a gallstone as large as 23.8 × 28.8 mm was successfully extracted through the ELLL method after it was broken into pieces smaller than 1 cm.…”

“…They initiated patients on regular supplementation of ursodeoxycholic acid to prevent re-formation of gallstones, with no recurrence of lithiasis 6 months post-ELLL [59]. Several authors have demonstrated large gallstone disintegration through EHL and subsequent extraction through LAMS, with smaller stones removed via washing, and larger particles removed with a retrieval basket [60,61]. Most data on this use of ELLL and EHL is through case reports, and larger trials are needed.…”