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Cálculo impactado no coto cístico - tratamento por litotrícia guiada por colangioscopia
Cálculo impactado no coto cístico - tratamento por litotrícia guiada por colangioscopia
Gonçalo Alexandrino, Luís C. Lourenço, David Horta, Jorge Reis, Jorge Canena
63 year-old male, previously submitted to cholecystectomy for Mirizzi Syndrome, admitted for jaundice and abdominal pain. There was a moderate increase in liver tests. The abdominal ultrasound showed choledochal dilatation and a calculus (about 12 mm) in the cystic stump, causing choledochal compression. He was submitted to ERCP that confirmed the diagnosis. Cholangioscopy was performed in the same procedure, visualizing the impacted calculus in the cystic stump (Figures 1 and 2). The stone was treated with electrohydraulic lithotripsy guided by cholangioscopy. At the end, cholangioscopy confirmed absence of lithiasis in the cystic stump (Figure 3).
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