Experience with mini-invasive endoscopic removal of gallstones

Early experience with mini-invasive endoscopic removal of gallstones in seriously ill patients has shown its usefulness and feasibility. By comparison with the percutaneous method of endoscopic stone removal, the open direct approach to the gallbladder fundus via mini-laparotomy requires less operating time. The larger opening in the fundus of the gallbladder permits the use of instruments simultaneously with the endoscope and removal of uncrushed gallstones. One creates very little stone debris and reduces the danger of sludge migrating into the cystic duct. To date, the method has only been employed in severely ill patients, but its future use in younger persons appears reasonable.