Bouveret Syndrome: A Surgery-Sparing Endoscopic Approach

Cholelithiasis is a common condition, and complications of gallstone disease include cholecystitis, cholangitis, pancreatitis, and, rarely, gallstone ileus or Bouveret syndrome. We present a case of a 79-year-old male with multiple comorbidities who was treated using endoscopic techniques to avoid the risks associated with surgery. The approach utilized holmium laser lithotripsy and electrohydraulic lithotripsy over multiple sessions to fragment and remove the large gallstone causing a duodenal obstruction. Conservative management of a subsequent duodenal perforation led to successful recovery. This case highlights the potential for endoscopic methods to manage gallstone ileus in high-risk patients, reducing complications and potentially avoiding surgery.