Successful treatment of Bouveret syndrome using holmium: YAG laser lithotripsy

Evan B. Goldstein, Richard H. Savel, H. Leon Pachter, Jonathan Cohen, Peter Shamamian

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Although gallstone disease is highly prevalent, cholelithiasis causing gallstone ileus is uncommon. Consideration has been given for nonoperative strategies to resolve obstruction due to the significant age and comorbidities afflicting this population. A 94-year-old man presented with a 5-day history of abdominal distension and tenderness. CT scan revealed multiple large gallstones within the gallbladder, pneumobilia, and two ectopic gallstones (antrum of the stomach and distal ileum). The patient was taken to the operating room where an enterolithotomy and gastrotomy was performed with removal of gallstones and subsequent relief of obstruction. During the postoperative course, the patient developed symptoms of gastric outlet obstruction and underwent gastrointestinal endoscopy for diagnosis and treatment. Two large gallstones, present in the duodenum, were retracted into the stomach using a Roth net but could not be retrieved beyond the upper esophageal sphincter. A holmium: yttrium-aluminum- garnet (Holmium: YAG) laser was used for fragmentation of the stones, with subsequent successful removal. This is the first documented successful use of the holmium: YAG laser for the treatment of recurrent gallstone ileus. Physicians should remember that in a small but important subgroup of patients, endoscopy accompanied by laser lithotripsy may prove beneficial.

Original languageEnglish (US)
Pages (from-to)882-885
Number of pages4
JournalAmerican Surgeon
Volume71
Issue number10
StatePublished - Dec 1 2005
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

Fingerprint Dive into the research topics of 'Successful treatment of Bouveret syndrome using holmium: YAG laser lithotripsy'. Together they form a unique fingerprint.

  • Cite this

    Goldstein, E. B., Savel, R. H., Pachter, H. L., Cohen, J., & Shamamian, P. (2005). Successful treatment of Bouveret syndrome using holmium: YAG laser lithotripsy. American Surgeon, 71(10), 882-885.