Endoscopic papillary large balloon dilation as a salvage procedure for basket impaction during retrieval of common bile duct stones

Results of the open surgery after endoscopic basket impaction during ERCP procedure

AIM: To report the results of open surgery for patients with basket impaction during endoscopic retrograde cholangiopancreatography (ERCP) procedure.

METHODS: Basket impaction of either classical Dormia basket or mechanical lithotripter basket with an entrapped stone occurred in six patients. These patients were immediately operated for removal of stone(s) and impacted basket. The postoperative course, length of hospital stay, diameter of the stone, complication and the surgical procedure of the patients were reported retrospectively.

RESULTS: Six patients (M/F, 0/6) were operated due to impacted basket during ERCP procedure. The mean age of the patients was 64.33 ± 14.41 years. In all cases the surgery was performed immediately after the failed ERCP procedure by making a right subcostal incision. The baskets containing the stone were removed through longitudinal choledochotomy with the stone. The choledochotomy incisions were closed by primary closure in four patients and T tube placement in two patients. All patients were also performed cholecystectomy additionally since they had cholelithiasis. In patients with T-tube placement it was removed on the 13^th day after a normal T-tube cholangiogram. The patients remained stable at postoperative period and discharged without any complication at median 7 d.

CONCLUSION: Open surgical procedures can be applied in patients with basket impaction during ERCP procedure in selected cases.