Lumen-apposing metal stent–assisted electrohydraulic lithotripsy and mechanical lithotripsy for cholelithiasis in a nonsurgical patient

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

“…Rarely, stone impaction and LAMS obstruction can occur. 2 , 3 In this scenario, EEHL is a useful technique that, by generating high-amplitude hydraulic pressure waves with repetitive pulses of energy to create a mechanical shockwave, 4 , 5 allows fragmentation of the impacted stone. EEHL may be a good option to treat LAMS obstruction in cholecysto-gastrostomy.…”

“… 1 However, recurrent cholecystitis with stone impaction is a possible adverse event in patients with large calculi. 2 We report the case of a patient with acute recurrent lithiasic cholecystitis who was deemed unfit for surgery owing to her age and multiple comorbidities and was then treated with cholecysto-gastrostomy.…”

Endoscopic Treatment of Acute Cholelithiasis Using AXIOS Stenting and Lithotripsy: A Case Series

“…Moreover, patients with ascites or on anticoagulation cannot undergo this procedure [4]. Recent advancements in EUS have led to endoscopic gallbladder decompression via the approach of transpupillary drainage or transmural stenting [4][5][6]. EUS-guided gallbladder decompression is minimally invasive with fewer complications, which is evidenced by numerous retrospective studies demonstrating high success rates, decreased leaks and/or stent migration, shorter hospital stays, and fewer unplanned admissions as compared to percutaneous drainage [4,5,7].…”

“…Though it has been well established over the last decade that endoscopic gallbladder decompression is a feasible, safe, and superior therapeutic modality for non-surgical candidates with acute cholecystitis, there remains the problem of patients with concomitant choledocholithiasis [ 6 ]. To our knowledge, only one other case report describes a patient who underwent both AXIOS stenting for biliary drainage as well as electrohydraulic lithotripsy for the treatment of calculous cholecystitis and choledocholithiasis [ 6 ]. Like the prior case report, both of our patients first had gallbladder decompression with the formation of a cholecystogastrostomy using the AXIOS stent system, and later, lithotripsy was performed in a subsequent procedure.…”

Electrohydraulic lithotripsy for the treatment of stone impacted in a lumen-apposing metal stent in a patient with endoscopic cholecystoduodenostomy

“…EUS-guided gallbladder drainage in patients who are not candidates for surgery is a safe technique and has a low complication rate. In patients with large stones, recurrent cholecystitis, impaction, and LAMS obstruction can occur [1,2]. EHL and laser lithotripsy are two useful techniques that allow fragmentation of stones; EHL generates high-amplitude hydraulic pressure waves, while laser lithotripsy uses a laser beam with repetitive pulses of laser energy to create a mechanical shockwave [3,4].…”