Percutaneous Endoscopy and Image-guided Retrieval of Dropped Gallstones - A Case Series.

IF 1.1 4区医学 Q3 SURGERY

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Pub Date : 2024-08-01 DOI:10.1097/SLE.0000000000001287

Ali Husnain, Allison Reiland, Albert A Nemcek, Riad Salem, Alexander P Nagle, Ezra Teitelbaum, Ahsun Riaz

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引用次数: 0

Abstract

Background: Recurrent abscesses can happen due to dropped gallstones (DGs) after laparoscopic cholecystectomy (LC). Recognition and appropriate percutaneous endoscopy and image-guided treatment options can decrease morbidity associated with this condition.

Materials and methods: We report a minimally invasive endoscopy and image-guided technique for retrieval of dropped gallstones in a series of 6 patients (M/F=3/3; median age: 75.5 years [68 to 82]) presenting with recurrent or chronic intra-abdominal abscesses secondary to dropped gallstones. Technical success was defined as the visualization and retrieval of all stones. DGs were identified on pre-procedure imaging. Number of abscesses recurrence was 12 (1/6), 1 (3/6), and 0 (2/6) with a median interval of 2 months (1 to 21) between cholecystectomy and abscess development.

Results: Percutaneous endoscopy and fluoroscopy guidance were utilized in all cases. Technical success was achieved in 4 patients (66%). The median procedure time was 65.8 minutes (39 to 136). The median fluoroscopy time and dose were 12.6 min (3.3 to 67) and 234 mGy (31 to 1457), respectively. There were no intraprocedure and postprocedure complications. No abscess recurrence was reported among successful procedures during a median follow-up of 193 days (51 to 308).

Conclusion: Percutaneous image and endoscopy-guided lithotripsy/lithectomy are safe and effective. This technique is a suitable alternative to open surgery for dropped gallstones.

Level of evidence: Level 4, Case Series.

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经皮内窥镜和图像引导取回掉落的胆结石--一个病例系列。

背景：腹腔镜胆囊切除术（LC）后，胆结石（DGs）脱落可导致复发性脓肿。识别并采取适当的经皮内镜和图像引导治疗方案可降低与这种情况相关的发病率：我们报告了一种微创内镜和图像引导技术，该技术适用于6例因胆结石掉落导致复发性或慢性腹腔内脓肿的患者（男/女=3/3；中位年龄：75.5岁[68至82岁]）。技术成功的定义是所有结石均被显露和取出。胆管结石是在手术前的影像学检查中发现的。脓肿复发次数分别为12次（1/6）、1次（3/6）和0次（2/6），胆囊切除术与脓肿形成之间的中位间隔为2个月（1至21个月）：所有病例均采用经皮内镜和透视引导。4名患者（66%）获得了技术成功。手术时间中位数为 65.8 分钟（39 至 136 分钟）。透视时间和剂量的中位数分别为 12.6 分钟（3.3 到 67 分钟）和 234 毫戈瑞（31 到 1457 毫戈瑞）。术中和术后均无并发症。在中位随访193天（51至308天）期间，成功的手术中没有脓肿复发的报告：结论：经皮图像和内窥镜引导碎石/肝切除术安全有效。结论：经皮图像和内窥镜引导碎石/取石术是安全有效的，该技术可替代开腹手术治疗掉落的胆结石：4级，病例系列。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 医学-外科

CiteScore

2.00

自引率

10.00%

发文量

103

审稿时长

3-8 weeks

期刊介绍： Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.