WHEN ENDOSCOPY PULLS CHESTNUTS OUT OF THE FIRE: A RARE CASE OF MIRIZZI´S SYNDROME TREATED WITH LASER LITHOTRIPSY BY DIRECT PERORAL CHOLANGIOSCOPY

Aim We present a case of Mirizzi syndrome treated conservatively using laser lithotripsy by direct peroral cholangioscopy.

Methods An 82-year-old-man was admitted due to abdominal pain and jaundice. CT-scan showed a type III of Mirizzi´s syndrome.

Results Considering patient’s comorbidity and sugical risk we performed an ERCP failing stone extraction. We used the SpyGlass System in order to fragment the stone trough holmium laser lithotripsy by positioning the fiber in contact with the stone; all fragments were finally removed.

Conclusions Holmium laser lithotripsy trough the SpyGlass System can help to remove CBD impacted stone in selected patients with Mirizzi´s syndrome.