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CC BY 4.0 · Endoscopy 2024; 56(S 01): E715
DOI: 10.1055/a-2371-1205
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Electrohydraulic lithotripsy: a safe and effective technique to retrieve an impacted Dormia basket

Sébastien Carbillet
1   Gastroenterology, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France (Ringgold ID: RIN36673)
,
Franck Brazier
1   Gastroenterology, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France (Ringgold ID: RIN36673)
,
Mathurin Fumery
1   Gastroenterology, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France (Ringgold ID: RIN36673)
,
Clara Yzet
1   Gastroenterology, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France (Ringgold ID: RIN36673)
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Choledocholithiasis is a common indication for endoscopic retrograde cholangiopancreatography (ERCP). Mechanical lithotripsy is a frequently used technique for the extraction of complex common bile duct (CBD) stones; however, impaction of the Dormia basket around a large stone and fracture of Dormia basket wires have been described in up to 6% of procedures [1] [2] [3]. This complication is one of the most challenging to treat, often requiring endoscopic, percutaneous, or surgical intervention, with a risk of morbidity and mortality.

We present the case of a 47-year-old woman who had been experiencing abdominal pain and jaundice for 10 days. A computed tomography scan revealed a dilated CBD, measuring 15 mm. An endoscopic ultrasound (EUS) identified a stone at the junction between the CBD and the cystic duct. Mechanical lithotripsy was attempted via ERCP, and the stone was grasped with the Dormia basket. Multiple attempts to crush and retrieve the stone were unsuccessful, resulting in impaction of the Dormia basket in the CBD owing to a wire fracture in the operating channel. We then decided to perform electrohydraulic lithotripsy (EHL) to dislodge the stone and retrieve the impacted basket ([Video 1]). An intraductal cholangioscope (SpyGlass) was introduced into the CBD and placed in contact with the stone, allowing EHL to be applied to pulverize the stone and enabling the removal of the Dormia basket with a grasper. The stone fragments were then retrieved with an extraction balloon.


Quality:
Electrohydraulic lithotripsy is performed to fragment an impacted common bile duct stone, allowing safe retrieval of an impacted Dormia basket.Video 1

Cholangioscopy-guided EHL is a safe and effective method for the retrieval of an impacted Dormia basket. This technique is a less invasive alternative to surgery.

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Conflict of Interest

The authors declare that they have no conflict of interest.

  • References

  • 1 Sauter G, Sackmann M, Holl J. et al. Dormia baskets impacted in the bile duct: release by extracorporeal shock-wave lithotripsy. Endoscopy 1995; 27: 384-387
    Thieme ConnectPubMedSearch in Google Scholar
  • 2 O’Brien J.W, Tyler R, Shaukat S. et al. Laparoscopic common bile duct exploration for retrieval of impacted Dormia basket following endoscopic retrograde cholangiopancreatography with mechanical failure: case report with literature review. Case Rep Surg 2017; 2017: 1-5
    PubMedSearch in Google Scholar
  • 3 Tandup C, Kaman L, Sinha SK. Surgical management of the impacted Dormia basket during ERCP. Int Surg J 2019; 6: 1783
    CrossrefPubMedSearch in Google Scholar

Correspondence

Clara Yzet, MD
Gastroenterology Unit, Amiens University Hospital
Rond-point du Professeur Cabrol
80054, Amiens
France   

Publication History

Article published online:
07 August 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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  • References

  • 1 Sauter G, Sackmann M, Holl J. et al. Dormia baskets impacted in the bile duct: release by extracorporeal shock-wave lithotripsy. Endoscopy 1995; 27: 384-387
    Thieme ConnectPubMedSearch in Google Scholar
  • 2 O’Brien J.W, Tyler R, Shaukat S. et al. Laparoscopic common bile duct exploration for retrieval of impacted Dormia basket following endoscopic retrograde cholangiopancreatography with mechanical failure: case report with literature review. Case Rep Surg 2017; 2017: 1-5
    PubMedSearch in Google Scholar
  • 3 Tandup C, Kaman L, Sinha SK. Surgical management of the impacted Dormia basket during ERCP. Int Surg J 2019; 6: 1783
    CrossrefPubMedSearch in Google Scholar

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