Mirizzi syndrome is a serious disease that, even today, causes significant morbidity and mortality, and is generally considered a
contraindication to laparoscopic surgery. Here, we describe a severe
cholecystitis patient who was treated successfully with percutaneous transhepatic gallbladder scopic
lithotripsy by
laser. The patient initially underwent percutaneous transhepatic gallbladder drainage. Subsequent examination revealed a gallbladder stone impacted in the cystic duct. As the patient had a short and thick cystic ductal lumen, we decided to try to crush the stones through the
fistula of the gallbladder drainage tube. We first dilated the
fistula until it was approximately 12 Fr in size and then performed the percutaneous transhepatic gallbladder scopic
lithotripsy procedure.
Laser lithotripsy was performed twice to ensure clearance of all stones, including those in the common bile duct. The result was successful nonoperative treatment of a patient with
Mirizzi syndrome involving a common bile duct stone, using
laser lithotripsy via a cholangiofiber scope. This case suggests that
laser lithotripsy is a feasible optional treatment method for severe
cholecystitis patients having a percutaneous drainage tube.