{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T11:47:38Z","timestamp":1747223258276,"version":"3.40.5"},"reference-count":17,"publisher":"Pensoft Publishers","issue":"3","license":[{"start":{"date-parts":[[2024,6,30]],"date-time":"2024-06-30T00:00:00Z","timestamp":1719705600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FM"],"abstract":"<jats:p>Bouveret\u2019s syndrome (BS) represents an exceedingly rare clinical entity characterized by gastric outlet obstruction induced by a gallstone passing through a cholecystoduodenal, cholecystogastric or choledochoduodenal fistula and impacting in the duodenum or pylorus. Endoscopy is the preferred first-line therapy. It has a favorable safety profile, but requires high level of expertise to achieve stone clearance.<\/jats:p>\n          <jats:p>We report here the case of a 75-year-old Caucasian male who presented with vomiting and upper gastrointestinal bleeding and was diagnosed with BS by upper endoscopy. A single session stone extraction utilizing mechanical lithotripsy and laser lithotripsy was executed. Complete clearance of the duodenum and gallbladder was achieved, extracting successfully all fragments larger than 5 mm.<\/jats:p>\n          <jats:p>The rarity of BS and its non-specific presentation makes it largely overlooked leading commonly to delayed diagnosis, which results in a high mortality rate of 12-30%. Computer tomography is the diagnostic method of choice. Upper endoscopy can establish the presence of obstruction, but fails to visualize a stone in up to 1\/3 of the cases. Management is either endoscopic or surgical. Endoscopic treatment has a good safety profile (mortality 1.6% vs. 17.5-25% for surgery) but poor success rate \u2013 43% vs. 94.1%. To achieve higher success rate, more advanced techniques are required such as mechanical or laser lithotripsy.<\/jats:p>\n          <jats:p>Laser lithotripsy is a feasible option for endoscopic treatment of BS, but the duration of the procedure might be an issue in frail patients.<\/jats:p>","DOI":"10.3897\/folmed.66.e106586","type":"journal-article","created":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T11:17:27Z","timestamp":1719919047000},"page":"415-420","source":"Crossref","is-referenced-by-count":1,"title":["Combined laser and mechanical lithotripsy for endoscopic management of Bouveret\u2019s syndrome: A case report"],"prefix":"10.3897","volume":"66","author":[{"given":"Bozhidar","family":"Hristov","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Doykov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Desislav","family":"Stanchev","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emiliya","family":"Nacheva-Georgieva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1155-117X","authenticated-orcid":true,"given":"Krasimir","family":"Kraev","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2064-173X","authenticated-orcid":true,"given":"Petar","family":"Uchikov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5137-6903","authenticated-orcid":true,"given":"Gancho","family":"Kostov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siyana","family":"Valova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4091-4312","authenticated-orcid":true,"given":"Eduard","family":"Tilkiyan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6433-7970","authenticated-orcid":true,"given":"Katya","family":"Doykova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7029-8397","authenticated-orcid":true,"given":"Mladen","family":"Doykov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2258","published-online":{"date-parts":[[2024,6,30]]},"reference":[{"key":"106586_B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2017.10.044"},{"key":"106586_B2","doi-asserted-by":"crossref","unstructured":"2. Haddad FG, Mansour W, Deeb L. Bouveret\u2019s syndrome: literature review. Cureus 2018; 10(3):e2299.","DOI":"10.7759\/cureus.2299"},{"key":"106586_B3","doi-asserted-by":"crossref","unstructured":"3. Jin L, Naidu K. Bouveret syndrome - a rare form of gastric outlet obstruction. J Surg Case Rep 2021; 2021(5):rjab183.","DOI":"10.1093\/jscr\/rjab183"},{"key":"106586_B4","doi-asserted-by":"crossref","unstructured":"4. Dumonceau JM, Devi\u00e8re J. Novel treatment options for Bouveret\u2019s syndrome: a comprehensive review of 61 cases of successful endoscopic treatment. Expert Rev Gastroenterol Hepatol 2016; 10(11):1245\u201355.","DOI":"10.1080\/17474124.2016.1241142"},{"key":"106586_B5","doi-asserted-by":"crossref","unstructured":"5. Ong J, Swift C, Stokell BG, et al. Bouveret syndrome: a systematic review of endoscopic therapy and a novel predictive tool to aid in management. 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