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DOI: 10.1055/a-1728-9526
Digital single-operator cholangioscopy with EHL as salvage therapy of an internalized and stone-impacted biliary stent 13 years after implantation
Supported by: H2020 European Research Council 771083Supported by: Deutsche Forschungsgemeinschaft CA 830/3-1,CRC1380/A01,LU 1360/3-1
We report the case of a 72-year-old patient who presented with an inadvertently remaining CBD stent that was completely internalized and heavily impacted by biliary concretions over its entire length 13 years after implantation. Following an unsuccessful conservative ERC salvage attempt, digital single-operator cholangioscopy (dSOC) in combination with electrohydraulic lithotripsy (EHL) was used to fragment the biliary concrements. Finally, after endoscopic papillary balloon dilatation up to 12 mm and removal of the fragmented concretions, the stent was successfully retrieved into the duodenum.
The development of technically advanced tools such as dSOC and dedicated instruments, including the SpyGlass Retrieval Snare and Retrieval Basket, have enabled removal of inadvertently proximally dislocated CBD stents. Our case shows that dSOC in combination with its instruments, such as EHL, is an effective and safe therapeutic option, even in special and rare cases such as this one, in which a stent was dislocated proximally and had become completely impacted by stones after 13 years.
Publication History
Article published online:
14 March 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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