Percutaneous Transhepatic Cholecystolithotomy by Holmium Laser for Non-high-Risk Patients with Symptomatic Gallbladder Stones

• Published in: Medical archives (Sarajevo, Bosnia and Herzegovina) Vol. 76; no. 1; pp. 29 - 33
• Main Authors: Binh, Nguyen Thai, Ly, Ngo-Thi Ly, Hien, Phan Nhan, Linh, Le Tuan, Lenh, Bui-Van, Duc, Nguyen Minh
• Format: Journal Article
• Language: English
• Published: Bosnia and Herzegovina Academy of Medical Sciences of Bosnia and Herzegovina 01-02-2022
• Subjects: Adult; Cholecystectomy, Laparoscopic; Female; Gallstones - surgery; Humans; Lasers, Solid-State - therapeutic use; Male; Middle Aged; Original Paper; Recurrence; cholecystolithotomy; transhepatic; holmium laser
• ISSN: 0350-199X; 1986-5961
• DOI: 10.5455/medarh.2022.76.29-33

The development of gallstones, also known as cholelithiasis, is one of the most common diseases associated with the gastrointestinal tract. In developing countries 10% to 15% of men and >25% of women experience gallstones.
The aim of the study was to evaluate the outcomes following percutaneous transhepatic cholecystolithotomy by holmium laser in non-high-risk patients with symptomatic gallbladder stones.
This was an intervention study without control and with longitudinal follow-up. Subjects included patients who had only gallbladder stones, a normal gallbladder contractility index, and required a conservative treatment.
The study included 44 patients (20 men, 24 women), with a mean age of 41.5 ± 13.4 years. The success rate was 97.7%, and only 1 of 44 patients required follow-up laparoscopic cholecystectomy. Gallstones were successfully removed from 43 of 44 patients (97.7%). The complication rate was 13.6% (6/44 patients), and only minor complications were reported for 5 of the 6 patients with complications. In 34 of 43 patients, follow-up examinations were performed after 1 and 6 months. The gallstone recurrence rate at six-month follow-up was 11.8%, and a collapsed gallbladder was detected in 1 of 34 patients, with the remaining 33 patients retaining normal gallbladder contractility indices (>40%).
Percutaneous transhepatic cholecystolithotomy by holmium laser has a high gallstone removal rate (97.7%); however, recurrence remains a major problem. The complication rate was about 13.6%, most of which were minor complications. Cases associated with treatment failure or serious complications should be detected and treated promptly.