Feasibility and Early Outcomes of Single-Session Percutaneous Cholecystolithotomy Using Holmium Laser Lithotripsy Followed by Primary Tract Closure via Cholecystopexy.

PURPOSE: To evaluate the feasibility and early outcomes of single-session percutaneous cholecystolithotomy using holmium laser lithotripsy with primary tract closure by cholecystopexy in patients with symptomatic gallbladder (GB) stones.

MATERIALS AND

METHODS

This retrospective study included 30 patients (mean age, 34.9 years [SD ± 11.3]; female, 64.4%) with symptomatic GB stones who underwent single-stage percutaneous cholecystolithotomy with primary tract closure between July 2023 and December 2024. A 16-F access sheath and rigid endoscope were used for GB endoscopy, with stone fragmentation via holmium laser lithotripsy and removal using a basket, the access tract was primarily closed after the procedure. Clinical success was defined as complete stone clearance. Adverse events (AEs) were classified by the Society of Interventional Radiology (SIR) classification.

RESULTS

The mean stone size was 14.2 mm (SD ± 5.9), and 80% had stones ≥ 10 mm; mean GB ejection fraction measured by ultrasound (US) was 71.8% (SD ± 13.1). Complete stone clearance was achieved in all cases. Mean procedure time was 48 minutes (SD ± 12). Primary tract closure was successful in 27 (90%) of 30 patients, with no evidence of bile leak following drain removal. Mean drainage duration was 3.3 days (SD ± 3.8); 76.7% required drainage for 1-3 days. Mean hospital stay was 2.9 days (SD ± 2.1). AEs occurred in 5 patients (16.7%), including bleeding (6.7%) and bile leakage (10%) and none requiring cholecystectomy. The mean follow-up duration was 14.5 months (SD ± 5.2), with 2 patients showing stone recurrence.

CONCLUSIONS

Single session of percutaneous cholecystolithotomy with primary tract closure is a feasible and effective method for symptomatic GB stones.