Acute calculous cholecystitis is the obstruction of the cystic duct by a gallstone that leads to inflammation of the gallbladder necessitating cholecystectomy. 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. 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.
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http://dx.doi.org/10.31486/toj.23.0071 | DOI Listing |
World J Urol
January 2025
Department of Urology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China.
Urologia
January 2025
Research Center for Evidence-Based Medicine, Iranian EBM Centre: A JBI Centre of Excellence, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
This Umbrella Review aims to gather high-quality evidence on urolithiasis outcomes and complications, comparing extracorporeal shockwave lithotripsy (ESWL), ureteroscopic lithotripsy (URSL), and retrograde intrarenal surgery (RIRS). We incorporated systematic reviews, some containing meta-analyses, into two separate reports, focusing on quantitative and qualitative results. Additionally, when data permitted, a secondary meta-analysis was conducted using final effect estimates from multiple meta-analyses.
View Article and Find Full Text PDFJ Vasc Surg Cases Innov Tech
April 2025
Department of Surgery, Westchester Medical Center, Valhalla, NY.
We present a case of an 86-year-old female with chronic mesenteric ischemia secondary to long-segment flush occlusion of the superior mesenteric artery and near-total occlusion of the celiac artery. The superior mesenteric artery was unable to be revascularized by conventional antegrade approaches. Successful transcollateral crossing of the occluded superior mesenteric artery and body-flossing, followed by antegrade balloon angioplasty, shockwave lithotripsy, and stent implantation were performed.
View Article and Find Full Text PDFBiomech Model Mechanobiol
January 2025
Cardiac Surgery Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA.
Percutaneous coronary interventions in highly calcified atherosclerotic lesions are challenging due to the high mechanical stiffness that significantly restricts stent expansion. Intravascular lithotripsy (IVL) is a novel vessel preparation technique with the potential to improve interventional outcomes by inducing microscopic and macroscopic cracks to enhance stent expansion. However, the exact mechanism of action for IVL is poorly understood, and it remains unclear whether the improvement in-stent expansion is caused by either the macro-cracks allowing the vessel to open or the micro-cracks altering the bulk material properties.
View Article and Find Full Text PDFPurpose Of Review: This review focuses on recent advancements in laser technologies used in urology, particularly in enucleation, vaporization, lithotripsy, and focal laser ablation (FLA). The growing use of the thulium fiber laser (TFL) and the development of pulsed thulium lasers (p-Tm:YAG) highlight the relevance of this review, as these innovations aim to improve precision and outcomes in urological procedures.
Recent Findings: Recent studies have shown the advantages of TFL in achieving precise tissue ablation, reduced retropulsion offered by the Moses technology in holmium lasers, and the potential of pulsed thulium lasers for more precise control of the effects on tissues.
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