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Percutaneous cholecystolithotomy.

M J Kellett¹, J E Wickham, R C Russell

¹Institute of Urology, London.

British Medical Journal (Clinical Research Ed.)

|February 13, 1988

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Percutaneous cholecystolithotomy offers a new minimally invasive option for gallstone removal. This single-stage procedure successfully removed gallstones in seven of eight patients, with no complications at three months.

Area of Science:

Minimally invasive surgery
Gastroenterology
Urology (procedural adaptation)

Background:

Gallstones (cholelithiasis) are common and often require intervention.
Traditional treatments include cholecystectomy and extracorporeal shockwave lithotripsy (ESWL).
Challenges exist with ESWL focusing and stone fragmentation, necessitating alternative approaches.

Purpose of the Study:

To evaluate the efficacy and safety of a novel percutaneous cholecystolithotomy technique.
To assess the feasibility of adapting percutaneous nephrolithotomy methods for gallstone removal.
To determine the potential role of this procedure as an adjunct to existing gallstone therapies.

Main Methods:

A single-stage percutaneous approach under general anesthesia was employed.

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Instruments and techniques similar to percutaneous nephrolithotomy were utilized.

A Foley catheter was placed in the gallbladder for drainage, with contrast checks at 10 days.

Main Results:

Successful percutaneous cholecystolithotomy was achieved in 7 out of 8 patients.
One patient required an uncomplicated cholecystectomy due to inability to secure an adequate percutaneous track.
Follow-up at three months revealed no residual calculi or complications in the successfully treated patients.

Conclusions:

Percutaneous cholecystolithotomy is a viable and effective minimally invasive option for gallstone removal.
The procedure demonstrates a high success rate and favorable short-term safety profile.
It may serve as a valuable complementary treatment for patients with difficult gallstone presentations, particularly those unsuitable for or incompletely treated by ESWL.