Combined Interventional Radiology and Surgical Cut-Down Approaches for Retained Gallstones

Area of Science:

• Gastroenterology
• Interventional Radiology
• Surgical Innovation

Background:

• Symptomatic retained gallstones are a rare complication following cholecystectomy.
• Vague abdominal complaints or perihepatic abscesses in post-cholecystectomy patients warrant consideration for retained gallstones.
• Traditional treatments included open surgery, but minimally invasive approaches are now standard.

Observation:

• This case report presents two unique combined surgical and interventional radiology methods for retained gallstone extraction.
• The first case utilized pre-operative needle-wire localization for precise stone identification and excision.
• The second case involved draining a surrounding abscess with a 10 French drain, guiding surgical extraction.

Findings:

• Both described combination methods successfully facilitated the removal of retained gallstones.
• These techniques were particularly effective for larger and deeper stones lodged in abscess cavities.
• The procedures highlight the synergy between interventional radiology and general surgery.

Implications:

• The proposed combined approach offers a viable solution for complex retained gallstone cases.
• This strategy may reduce the morbidity associated with traditional open surgical interventions.
• Further investigation into these combined techniques could refine management protocols for retained gallstones.