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Development of a hybrid percutaneous-endoscopic approach for the complete clearance of gallstones
Barham K Abu Dayyeh1, Todd H Baron
1Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Insights
Cholecystitis management needs better options. A new hybrid technique offers complete gallstone clearance for non-surgical patients, potentially improving treatment for symptomatic gallstone disease.
Area of Science:
- Gastroenterology and Hepatobiliary Surgery
- Minimally Invasive Procedures
Background:
- Cholecystitis is a prevalent and expensive condition.
- Cholecystectomy is the standard curative treatment.
- Nonsurgical alternatives are limited by incomplete gallstone clearance.
Observation:
- A novel hybrid percutaneous-endoscopic approach was developed.
- This technique was applied to an elderly patient unsuitable for surgery.
- The approach aimed for complete gallstone clearance.
Findings:
- The hybrid technique successfully achieved complete gallstone clearance.
- This case demonstrates a potential new minimally invasive option.
- The patient was not a candidate for traditional cholecystectomy.
Implications:
- This hybrid approach may offer a safer alternative for high-risk patients.
- Further research is needed to validate safety and efficacy.
- It could expand treatment options for symptomatic gallstone disease.
Abstract:
Cholecystitis is common and costly to the health care system. Cholecystectomy is curative and the treatment of choice. Alternatives to cholecystectomy, however, are needed for patients who cannot undergo this surgery. However, procedures such as percutaneous cholecystostomy, endoscopic transpapillary and transduodenal gallbladder drainage, and dissolution therapy have limitations such as continued gallstone burden. More effective and minimally invasive alternatives, therefore, are needed. We developed a hybrid percutaneous-endoscopic approach for complete gallstone clearance in an elderly patient who was not a candidate for surgery. If replicated and proven to be safe, this technique could be a minimally invasive alternative to cholecystectomy for patients with symptomatic gallstone disease who are not good candidates for surgery.
