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Chen Y, Yang L, Yang T, Liu C, Chen J. Pancreatic sphincterotomy allows removal of a fractured stone basket trapped in the pancreatic duct after lithotripsy. Endoscopy 2023; 55:E949-E950. [PMID: 37647933 PMCID: PMC10468266 DOI: 10.1055/a-2134-8947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Affiliation(s)
- Yan Chen
- Digestive Endoscopy Center, Changhai Hospital, Shanghai, China
- Department of Gastroenterology, Changhai Hospital, Shanghai, China
| | - Li Yang
- Digestive Endoscopy Center, Changhai Hospital, Shanghai, China
| | - Ting Yang
- Digestive Endoscopy Center, Changhai Hospital, Shanghai, China
| | - Cui Liu
- Digestive Endoscopy Center, Changhai Hospital, Shanghai, China
| | - Jie Chen
- Digestive Endoscopy Center, Changhai Hospital, Shanghai, China
- Department of Gastroenterology, Changhai Hospital, Shanghai, China
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Abu Shakra I, Bez M, Bickel A, Badran M, Merei F, Ganam S, Kassis W, Kakiashvili E. Emergency open surgery with a duodenotomy and successful removal of an impacted basket following a complicated endoscopic retrograde cholangiopancreatography procedure: a case report. J Med Case Rep 2021; 15:93. [PMID: 33618756 PMCID: PMC7901177 DOI: 10.1186/s13256-020-02608-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 11/30/2020] [Indexed: 12/14/2022] Open
Abstract
Background Current management of choledocholithiasis entails the use of endoscopic retrograde cholangiopancreatography (ERCP) and clearance of the common bile duct. A rare complication of this procedure is the impaction of the basket by a large stone, which necessitates lithotripsy. Here we report a case of an impacted basket during ERCP, which was managed by open surgery with a duodenotomy and the manual removal of the basket. Case presentation A 79-year-old Caucasian man was admitted to our department with yellowish discoloration of urine, skin and eyes. Abdominal ultrasonography showed a slightly thickened gallbladder, multiple gallbladder stones, dilated intrahepatic bile ducts and extrahepatic bile extending to 1.1 cm. A computed tomography (CT) scan demonstrated a stone in the common bile duct, which caused dilation of the biliary ducts. The patient was diagnosed with obstructive jaundice secondary to choledocholithiasis; and underwent an ERCP, a sphincterotomy and stone extraction. Four days following discharge, the patient was readmitted with jaundice, abdominal pain, vomiting and fever. He was diagnosed with ascending cholangitis and treated initially with antibiotics. A second ERCP revealed a dilated common bile duct and choledocholithiasis. Stone removal with a basket failed, as did mechanical lithotripsy. Finally, the wires of the basket were ruptured and stacked in the common bile duct together with the stone. During exploratory laparotomy, adhesiolysis, a Kocher maneuver of the duodenum and a subtotal cholecystectomy were performed. Choledochotomy did not succeed in removing the impacted wires together with the stone. Therefore, a duodenotomy and an extension of the sphincterotomy were performed, followed by high-pressure lavage of the common bile duct to remove additional small biliary stones. The choledochotomy and duodenotomy were closed by a one-layer suture, and a prophylactic gastroenterostomy was performed to prevent leakage from the common bile duct and the duodenum. The postoperative course was satisfactory. Conclusions This is the first report in the literature of removal of an impacted Dormia basket through the papilla by performing a duodenotomy and an extension of the sphincterotomy, followed by gastroenterostomy.
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Affiliation(s)
- Ibrahim Abu Shakra
- Department of Surgery A, Galilee Medical Center, 22100, Nahariya, Israel
| | - Maxim Bez
- Medical Corps, Israel Defense Forces, Ramat Gan, Israel
| | - Amitai Bickel
- Department of Surgery A, Galilee Medical Center, 22100, Nahariya, Israel.,Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
| | - Mahran Badran
- Department of Surgery A, Galilee Medical Center, 22100, Nahariya, Israel
| | - Fahed Merei
- Department of Surgery A, Galilee Medical Center, 22100, Nahariya, Israel
| | - Samer Ganam
- Department of Surgery A, Galilee Medical Center, 22100, Nahariya, Israel
| | - Walid Kassis
- Department of Surgery A, Galilee Medical Center, 22100, Nahariya, Israel
| | - Eli Kakiashvili
- Department of Surgery A, Galilee Medical Center, 22100, Nahariya, Israel. .,Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.
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Lee Y, Park SM, Han JH. Use of a lithotripter to salvage a bile duct stone and kinking retrieval basket in the distal common bile duct. Dig Endosc 2019; 31:e32-e33. [PMID: 30427549 DOI: 10.1111/den.13295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 11/08/2018] [Indexed: 02/08/2023]
Affiliation(s)
- Yunhyeong Lee
- Department of Internal Medicine, Konkuk University Chungju Hospital, Chungju, South Korea
| | - Seon Mee Park
- Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, South Korea.,Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, South Korea
| | - Joung-Ho Han
- Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, South Korea.,Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, South Korea
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Doshi B, Yasuda I, Ryozawa S, Lee GH. Current endoscopic strategies for managing large bile duct stones. Dig Endosc 2018; 30 Suppl 1:59-66. [PMID: 29658655 DOI: 10.1111/den.13019] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 01/11/2018] [Indexed: 12/14/2022]
Abstract
Common bile duct stones are a relatively common occurrence and can often lead to devastating complications. Endoscopic retrograde cholangiopancreatography was introduced in the 1970s for management of common bile duct stones. Most common bile duct stones can be removed with simple techniques such as endoscopic sphincterotomy and balloon trawling. However, large bile duct stones continue to pose some difficulty in achieving complete extraction. In this article, we will review some of the established techniques such as the use of endoscopic papillary large balloon dilatation, mechanical lithotripsy, and cholangioscopy-assisted techniques. We will look at the recent literature to help clarify the particular methods and answer some of the questions surrounding these methods.
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Affiliation(s)
- Bhavesh Doshi
- National University Health System, Division of Gastroenterology and Hepatology, University Medicine Cluster, Singapore
| | - Ichiro Yasuda
- Department of Gastroenterology, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan
| | - Shomei Ryozawa
- Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Guan Huei Lee
- National University Health System, Division of Gastroenterology and Hepatology, University Medicine Cluster, Singapore
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Bhanthumkomol P, Aswakul P, Prachayakul V. Argon plasma coagulation for the resolution of basket impaction from large common bile duct stones. Endosc Int Open 2016; 4:E389-90. [PMID: 27092316 PMCID: PMC4831937 DOI: 10.1055/s-0042-100905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 01/04/2016] [Indexed: 10/27/2022] Open
Affiliation(s)
| | - Pitulak Aswakul
- Liver and Digestive Institute, Samitivej Sukhumvit Hospital, Bangkok, Thailand
| | - Varayu Prachayakul
- Siriraj GI Endoscopy Center, Siriraj Hospital; Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Mahidol University, Bangkok, Thailand,Corresponding author Varayu Prachayakul, MD Siriraj GI Endoscopy CenterSiriraj HospitalDivision of GastroenterologyDepartment of Internal MedicineFaculty of MedicineMahidol UniversityBangkok 10700Thailand+66-2-4120188
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Kim CW, Chang JH, Kim TH, Han SW. Rescue balloon dilation of the ampulla for retrieving an impacted biliary extraction basket. J Dig Dis 2014; 15:636-9. [PMID: 25139476 DOI: 10.1111/1751-2980.12181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Chang Whan Kim
- Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea
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Young Bang J, Coté GA. Rare and underappreciated complications of endoscopic retrograde cholangiopancreatography. TECHNIQUES IN GASTROINTESTINAL ENDOSCOPY 2014. [DOI: 10.1016/j.tgie.2014.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Chavalitdhamrong D, Donepudi S, Pu L, Draganov PV. Uncommon and rarely reported adverse events of endoscopic retrograde cholangiopancreatography. Dig Endosc 2014; 26:15-22. [PMID: 24118211 DOI: 10.1111/den.12178] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 08/21/2013] [Indexed: 02/06/2023]
Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) has become a primary tool for the treatment of biliary and pancreatic ductal diseases. It is essential for the endoscopist carrying out the ERCP to have a thorough understanding of the potential adverse events. Typically, endoscopists are well familiar with common adverse events such as post-ERCP pancreatitis, cholangitis, post-sphincterotomy bleeding, post-sphincterotomy perforation, and sedation-related cardiopulmonary compromises. However, there are other less common adverse events that arecritical to promptly recognize in order to provide appropriate therapy and prevent disastrous outcomes. This review focuses on the presentation and management of the less common and rare adverse events of an ERCP from the perspective of the practicing endoscopist.
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Affiliation(s)
- Disaya Chavalitdhamrong
- Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, USA
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Khawaja FI, Ahmad MM. Basketing a basket: A novel emergency rescue technique. World J Gastrointest Endosc 2012; 4:429-31. [PMID: 23125902 PMCID: PMC3487192 DOI: 10.4253/wjge.v4.i9.429] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2011] [Revised: 07/15/2012] [Accepted: 09/12/2012] [Indexed: 02/05/2023] Open
Abstract
Fracture of the central lead wire of an impacted basket during a mechanical lithotripsy for large common bile duct (CBD) stones poses a special challenge. Different maneuvers have been described to resolve this problem. Most techniques require equipment or facilities which may not be readily available in small community hospitals. We present here a similar situation in a patient with a large stone at the level of the cystic duct. Through the duodenoscope, a smaller Dormia basket was introduced into the CBD along the side of the impacted broken basket. The tip of the impacted basket was grasped and, by pulling downwards, the basket was disengaged from the stone. The two baskets were then removed successfully. We suggest this simple technique should be tried initially, before resorting to more advanced procedures.
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Affiliation(s)
- Fazal Imtiaz Khawaja
- Fazal Imtiaz Khawaja, Mohammed Mushtaque Ahmad, Department of Gastroenterology and Hepatology, King Fahad Hospital, Al-Madinah Al-Munwarah 41441, Saudi Arabia
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A novel two-step approach for retrieval of an impacted biliary extraction basket. Case Rep Gastrointest Med 2012; 2012:435050. [PMID: 22953076 PMCID: PMC3431071 DOI: 10.1155/2012/435050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Accepted: 07/24/2012] [Indexed: 01/01/2023] Open
Abstract
Biliary extraction baskets are a commonly used instrument for the removal of choledocholithiasis in endoscopic retrograde cholangiopancreatography (ERCP). Impaction of the extraction basket is a recognized complication of ERCP, and is usually the result of discrepancy between the size of bile duct stone and the diameter of the distal bile duct. Whilst mechanical lithotriptors can be used to crush the stone or break the wires of the basket to allow its release, failure of the lithotriptor device can occur. We describe the case of a 59-year-old gentleman who had an ERCP performed for choledocholithiasis. Basket impaction was encountered, and the mechanical lithotriptor failed to dislodge the stone/basket complex. A two-step technique involving balloon dilatation and forceps manipulation of the basket was applied to successfully dislodge the impacted basket. We believe this simple and safe technique should be adopted to rescue impacted biliary extraction baskets to avoid the need for potential surgical removal.
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