Letter to the Editor
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 21, 2022; 28(7): 763-765
Published online Feb 21, 2022. doi: 10.3748/wjg.v28.i7.763
Gallbladder biliary lithotripsy: A new rationale applied to old treatment
Lorenzo Dioscoridi, Massimiliano Mutignani
Lorenzo Dioscoridi, Massimiliano Mutignani, Digestive Endoscopy Unit, ASST Niguarda, Milan 20100, Italy
Author contributions: Dioscoridi L and Mutignani M designed research; Dioscoridi L wrote the letter; Mutignani M revised the letter.
Conflict-of-interest statement: None of the authors declare any conflict of interests related to the present paper.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lorenzo Dioscoridi, MD, PhD, Surgeon, Teacher, Digestive Endoscopy Unit, ASST Niguarda, Piazza dell'Ospedale Maggiore 3, Milan 20100, Italy. dioscoridi.lorenzo@virgilio.it
Received: July 27, 2021
Peer-review started: July 27, 2021
First decision: October 3, 2021
Revised: November 5, 2021
Accepted: January 19, 2022
Article in press: January 19, 2022
Published online: February 21, 2022

Pure endoscopic treatment of combined cholelithiasis and choledocholithiasis is possible due to the chance to use together both endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) approaches. This endotherapy permits to treat biliary stones in the main bile duct by standard ERCP and gallbladder stones by EUS-guided cholecystoduodenostomy eventually associated to intracorporeal lithotripsy to achieve optimal results.

Keywords: Endoscopic ultrasound-guided gallbladder drainage, Biliary lithotripsy, Gallstone lithotripsy, Gallbladder biliary lithotripsy, New rationale

Core Tip: Combining endoscopic approaches of endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) let to treat simultaneously biliary stones both in the gallbladder and in the main bile ducts. ERCP standard approach can be associated to EUS-guided gallbladder drainage to avoid recurrences in patients unfit for surgery. To optimize this treatment, gallbladder stones can be fragmented by intracorporeal lithotripsy so their fragments can easily pass through the stent in place for cholecystoduodenostomy. This mininvasive approach seems promising on the base of available literature.