Bouveret Syndrome: A Surgery-Sparing Endoscopic Approach

Area of Science:

• Gastroenterology
• Endoscopic procedures
• Gallstone disease management

Background:

• Gallstone disease is common, with potential complications including gallstone ileus.
• Surgical intervention for gallstone ileus carries risks, especially in elderly patients with comorbidities.

Observation:

• A 79-year-old male presented with duodenal obstruction caused by a large gallstone.
• The patient had multiple comorbidities, making surgery a high-risk option.

Findings:

• Endoscopic techniques, including holmium laser lithotripsy and electrohydraulic lithotripsy, were used over multiple sessions.
• These endoscopic methods successfully fragmented and removed the obstructing gallstone.
• Conservative management of a subsequent duodenal perforation resulted in successful patient recovery.

Implications:

• Endoscopic management of gallstone ileus is a viable alternative to surgery in high-risk patients.
• This approach can reduce complications and improve outcomes for complex gallstone disease.
• Minimally invasive endoscopic techniques offer a promising strategy for managing challenging gastrointestinal obstructions.