Case Report
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Jun 14, 2010; 16(22): 2832-2834
Published online Jun 14, 2010. doi: 10.3748/wjg.v16.i22.2832
Impaction of a lithotripsy basket during endoscopic lithotomy of a common bile duct stone
Nobutada Fukino, Takatsugu Oida, Atsushi Kawasaki, Kenji Mimatsu, Youichi Kuboi, Hisao Kano, Sadao Amano
Nobutada Fukino, Takatsugu Oida, Atsushi Kawasaki, Kenji Mimatsu, Youichi Kuboi, Hisao Kano, Department of Surgery, Social Insurance Yokohama Central Hospital, 268 Yamashita-cho, Naka-ku, Yokohama 231-8553, Japan
Sadao Amano, Department of Surgery, Nihon University School of Medicine, 30-1 Oyaguchi, Kami-machi, Itabashi-ku, Tokyo 173-8610, Japan
Author contributions: Fukino N, Oida T, Kawasaki A, Mimatsu K, Kuboi Y and Kano H carried out the operation and were consultants overseeing the patient’s care; Fukino N wrote the manuscript; Amano S was responsible for drafting the manuscript and revising it critically.
Correspondence to: Takatsugu Oida, MD, Department of Surgery, Social Insurance Yokohama Central Hospital, 268 Yamashita-cho, Naka-ku, Yokohama 231-8553, Japan. oida.takatsugu@yokochu.jp
Telephone: +81-45-6411921   Fax: +81-45-6719872
Received: December 30, 2009
Revised: January 27, 2010
Accepted: February 4, 2010
Published online: June 14, 2010
Abstract

The treatments for common bile duct (CBD) stones are being continually developed. Impaction of the lithotripsy basket during endoscopic removal of CBD stones was seen in 5.9% patients. We report the case of a 66-year-old woman who underwent surgery for the removal of an impacted biliary basket. She was admitted to our hospital with a complaint of right upper abdominal pain. Magnetic resonance cholangiopancreatography revealed a CBD stone (20 mm × 15 mm). We diagnosed her with choledocholithiasis and performed endoscopic retrograde cholangiopancreatography to remove the stone. However, unfortunately, the retrievable basket around the stone became impacted. An endotriptor along with forceps could not be used owing to the entrapment of the basket, and thus we performed urgent surgery. The basket containing the stone was removed through a longitudinal choledochotomy. The wires leading to the basket were cut, and the basket containing the stone was removed via the incision. A T-tube was inserted, and the choledochotomy was closed. The postoperative course was uneventful. In conclusion, if the diameter of a CBD stone is more than 20 mm, then the risk of basket impaction increases, and surgery may be necessary as the initial treatment of the CBD stone.

Keywords: Common bile duct gallstones, Impacted biliary basket, Lithotripsy