Lessons learnt from a case of extracorporeal shockwave lithotripsy for a residual gallbladder stone.

Abstract

INTRODUCTION:

Extracorporeal shockwave lithotripsy (ECSWL) for gallstones is rarely used due to high recurrence rates, but has been reported to be effective in some circumstances.

PRESENTATION OF CASE:

We describe a case of a failed attempt at laparoscopic cholecystectomy due to gallbladder contraction and complete obliteration of Calot's triangle. Cholecystotomy was performed to remove all visible stones, and completed by a subtotal cholecystectomy and closure of the gallbladder remnant. The patient remained symptomatic due to a residual stone in the Hartmann's pouch. ECSWL was attempted to fragment the stone; however, follow-up imaging showed persistence of the calculus.

DISCUSSION:

Literature review shows that ECSWL for multiple gallbladder stones has a low success rate. Even if a stone is successfully fragmented, a diseased gallbladder remnant seems incapable of expelling the fragments. Without completion endoscopic clearance, therefore, the treatment is considered incomplete.

CONCLUSION:

Our case suggests that ECSWL is ineffective in management of residual gallbladder stones after failed cholecystectomy.

• Authors: Sadik Quoraishi, Jake Ahmed, Andrew Ponsford, Ashraf Rasheed
• Journal: International journal of surgery case reports (Int J Surg Case Rep) Vol. 32 Pg. 43-46 ( 2017) ISSN: 2210-2612 [Print] Netherlands
• PMID: 28235649 (Publication Type: Journal Article)
• Copyright: Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.