# Successful Percutaneous Ultrasonic Lithotripsy of Gallstones

## TL;DR

A new method using ultrasonic lithotripsy successfully removed large gallstones in patients who couldn't undergo traditional surgery.

## Contribution

Percutaneous ultrasonic lithotripsy is introduced as an effective alternative for challenging gallstone removal.

## Key findings

- Two patients with large gallstones were successfully treated using percutaneous ultrasonic lithotripsy.
- The method proved effective when electrohydraulic lithotripsy failed.
- An interdisciplinary approach improved outcomes for high-risk patients.

## Abstract

Background: Acute calculous cholecystitis is the obstruction of the cystic duct by a gallstone that leads to inflammation of the gallbladder necessitating cholecystectomy.

Case Series: We present the cases of 2 patients with acute calculous cholecystitis who were deemed ineligible candidates for cholecystectomy because of their complicating medical histories. Both patients initially underwent cholecystostomy and drain placement with interventional radiology for management of acute calculous cholecystitis. Their large gallstones remained refractory to attempts at removal by electrohydraulic lithotripsy via the cholecystostomy access. The patients’ gallstones were successfully removed via percutaneous ultrasonic lithotripsy during a collaborative procedure with interventional radiology and urology.

Conclusion: An interdisciplinary approach using percutaneous cholecystolithotomy with rigid ultrasonic lithotripsy is an effective method for removing challenging gallstones in patients for whom traditional approaches fail.