Commentary

Technological development in intraductal visualization (cholangioscopy/choledochoscopy) has greatly advanced the assessment and management of biliary strictures and stones. This interesting case by Jinxin Li et al. demonstrates the additional role of cholangioscopy in troubleshooting. Standard stone removal of intraductal stones with a basket at endoscopic retrograde cholangiopancreatography (ERCP) was complicated by the basket’s “getting stuck.” Surprisingly, this was not related to stones, but due to the basket catching a gallbladder-jejunostomy drain in the bile duct. The problem was well demonstrated at cholangioscopy, and by “nibbling through” the plastic tubing with biopsy forceps under direct vision the basket was disengaged from the tubing. Rapid progress in cholangioscope design and accessories will likely provide additional tools and options for resolving both expected and unexpected challenges in pancreaticobiliary endoscopy.

Publication History

Article published online:
22 April 2025