Giant choledocholithiasis treated by mechanical lithotripsy using a gastric bezoar basket
Mechanical lithotripsy （ML） is usually considered as a standard treatment option for large bile duct stones. However, it is impossible to retrieve oversized stones because the conventional lithotripsy basket may not be able to grasp the stone. However, there is no es- tablished endoscopic extraction...
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| Published in: | World journal of gastroenterology : WJG Vol. 18; no. 25; pp. 3327 - 3330 |
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| Main Author: | |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
Baishideng Publishing Group Co., Limited
07-07-2012
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Mechanical lithotripsy （ML） is usually considered as a standard treatment option for large bile duct stones. However, it is impossible to retrieve oversized stones because the conventional lithotripsy basket may not be able to grasp the stone. However, there is no es- tablished endoscopic extraction method for such gi- ant stone removal. We describe a case of successful extraction of a 4-cm large stone using a gastric bezoar basket. A 78-year-old woman had suffered from upper abdominal pain for 20 d. Contrast-enhanced computed tomogram revealed a 4-cm single stone in the distal common bile duct （CBD）. Endoscopic stone retraction was decided upon and endoscopic papillary balloon dilation was performed using a large balloon. An at- tempt to capture the stone using a standard lithotripsy basket failed due to the large stone size. Subsequently, we used a gastric bezoar basket to successfully capturethe stone. The stone was fragmented into small pieces and extracted. The stone was completely removed after two sessions of endoscopic retrograde cholangio- pancreatography; each of which took 30 rain. No com- plications occurred during or after the procedure. The patient was fully recovered and discharged on day 11 of hospitalization. ML using a gastric bezoar basket is a safe and effective retrieval method in select cases, and is considered as an alternative nonoperative option for the management of difficult CBD stones. |
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| Bibliography: | Hyun .lung Chung, Seok Jeong, Don Haeng Lee, .lung II Lee, Jin-Woo Lee, Byoung Wook Bang, Kye Sook Kwon, Hyung Kil Kim, Yong Woon Shin, Young Soo Kim, Division of Gastroenterology, Department of Internal Medicine, Inha Uni- versity School of Medicine, Incheon 400-711, South Korea Mechanical lithotripsy （ML） is usually considered as a standard treatment option for large bile duct stones. However, it is impossible to retrieve oversized stones because the conventional lithotripsy basket may not be able to grasp the stone. However, there is no es- tablished endoscopic extraction method for such gi- ant stone removal. We describe a case of successful extraction of a 4-cm large stone using a gastric bezoar basket. A 78-year-old woman had suffered from upper abdominal pain for 20 d. Contrast-enhanced computed tomogram revealed a 4-cm single stone in the distal common bile duct （CBD）. Endoscopic stone retraction was decided upon and endoscopic papillary balloon dilation was performed using a large balloon. An at- tempt to capture the stone using a standard lithotripsy basket failed due to the large stone size. Subsequently, we used a gastric bezoar basket to successfully capturethe stone. The stone was fragmented into small pieces and extracted. The stone was completely removed after two sessions of endoscopic retrograde cholangio- pancreatography; each of which took 30 rain. No com- plications occurred during or after the procedure. The patient was fully recovered and discharged on day 11 of hospitalization. ML using a gastric bezoar basket is a safe and effective retrieval method in select cases, and is considered as an alternative nonoperative option for the management of difficult CBD stones. 14-1219/R Giant choledocholithiasis; Mechanical litho-tripsy; Bezoar basket; Common bile duct stone; Endo-scopic papillary balloon dilatal~ion ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3 Telephone: +82-32-8902548 Fax: +82-32-8902549 Correspondence to: Seok Jeong, MD, Division of Gastroenterology, Department of Internal Medicine, Inha University School of Medicine, 7-206, 3-Ga, Sinheung-Dong, Jung-Gu, Incheon 400-711, South Korea. inos@inha.ac.kr Author contributions: Chung HJ contributed to the conception and design of the paper; Jeong S critically revised the article for important intellectual content and performed the final approval of the article; Lee DH drafted the article; Lee JI, Lee JW, Bang BW, Kwon KS, Kim HK, Shin YW and Kim YS contributed to the administrative, technical, and logistic support. |
| ISSN: | 1007-9327 2219-2840 |
| DOI: | 10.3748/wjg.v18.i25.3327 |