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Successful treatment of an impacted lithotripter basket in the common bile duct with intracorporeal electrohydraulic lithotripsy

2018; Thieme Medical Publishers (Germany); Volume: 50; Issue: 04 Linguagem: Inglês

10.1055/s-0043-124176

1438-8812

Justine Fenner, Michael P. Croglio, Demetrios Tzimas, Juan Carlos Bucobo,

Pediatric Hepatobiliary Diseases and Treatments

A 62-year-old woman with hypothyroidism and hypertension presented to an outside hospital with abdominal pain. She was found on her initial workup to have choledocholithiasis and was transferred to our institution for endoscopic retrograde cholangiopancreatography (ERCP). The cholangiogram demonstrated common bile duct (CBD) dilatation, with right and left hepatic duct dilatation ([Fig. 1 a]). When mechanical lithotripsy to break up the stone was attempted, the stone and basket became impacted in the distal CBD during extraction ([Fig. 1 b]). An emergency lithotripter (Olympus America, Center Valley, Pennsylvania, USA) was used to release the basket from around the stone, but the device broke owing to a mechanical malfunction and the wires of the basket were severed near the handle and sheath. Direct cholangioscopy was then performed with electrohydraulic lithotripsy (EHL) to fragment the stone ([Fig. 2]), although further attempts were unsuccessful.