Endoscopic cholecystolithotomy using Holmium laser after EUS-guided gallbladder drainage – a case report

Abstract Text An 86-year-old woman was admitted with fever and vomiting.CT scan showed an acute cholecystitis complicated by a large liver abscess. Since the patient was unfit for surgery, an EUS-guided GB drainage was performed with a trans-gastric approach using a 15 mm Hot AXIOS Stent.A follow up CT scan showed a size reduction of the abscess and a residual gallstone next to the LAMS. At the endoscopic evaluation the LAMS was completely occluded by the residual stone. Endoscopic lithotripsy was performed using Holmium laser (HL). After accessing through the fistula, the HL split the stone in smaller fragments. Therefore HL after EUS-guided GBD should enter the shortlist of treatments in frail patients with gallstones [1] [2] [3].