E1512. Percutaneous Cholangioscopy and Gallstone Extraction: An Inside Look into Patient Workup, Management, and Procedural Techniques
  1. Meagan Vaitses; Mather Hospital
  2. Giovanni Santoro; Mather Hospital
  3. Kenny Lien; Mather Hospital
  4. Michael Dayan; Mather Hospital
  5. Diljot Dhillon; Mather Hospital
  6. Siddhant Kulkarni; Mather Hospital
  7. Benjamin Rajan; Mather Hospital
Cholelithiasis is a common condition resulting in significant morbidity among patients. Cholecystitis and choledocholithiasis are commonly treated by surgeons and gastroenterologists. Interventional radiologists are generally tasked with performing percutaneous cholecystostomy in patients who are poor surgical candidates. However, with recently advancements in tools and minimally invasive techniques, the role of the interventional radiologist has expanded to include treatment of patients with symptomatic cholelithiasis via percutaneous cholecystoscopy, electrohydraulic lithotripsy, and stone extraction.

Educational Goals / Teaching Points
Describe the role of interventional radiology in treating symptomatic cholelithiasis using a case based approach, discuss relevant fluoroscopic and endoscopic techniques, and review the devices used including lithotripsy and stone retrieval baskets, and discuss pertinent clinical workup, indications/contraindications, and postprocedural care.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We will provide a brief review of relevant preprocedural imaging, including the ultrasound and CT imaging findings of choledocholithiasis and cholecystitis. Additionally, we will provide an overview of percutaneous cholecystostomy, fluoroscopic cholangiography, and endoscopic cholecystoscopy.

The role of interventional radiology continues to expand as the demand for minimally invasive procedures rises. Although surgical cholecystectomy is the preferred treatment for acute cholecystitis, many patients with multiple medical comorbidities are poor surgical candidates, and are often managed via percutaneous cholecystostomy. Now, the role interventional radiology goes beyond tube placement and management. Percutaneous cholecystoscopy and stone extraction performed by the interventional radiologist is a safe and effective treatment that allows for continuity of care and provides much needed relief to patients suffering from symptomatic cholelithiasis.