Case Report
Copyright ©2012 Baishideng. All rights reserved.
World J Gastrointest Endosc. Sep 16, 2012; 4(9): 429-431
Published online Sep 16, 2012. doi: 10.4253/wjge.v4.i9.429
Basketing a basket: A novel emergency rescue technique
Fazal Imtiaz Khawaja, Mohammed Mushtaque Ahmad
Fazal Imtiaz Khawaja, Mohammed Mushtaque Ahmad, Department of Gastroenterology and Hepatology, King Fahad Hospital, Al-Madinah Al-Munwarah 41441, Saudi Arabia
Author contributions: Khawaja FI performed the ERCP and revised the manuscript for final submission; Ahmad MM assisted with the ERCP and prepared the manuscript.
Correspondence to: Fazal Imtiaz Khawaja, MD, FACG, Department of Gastroenterology and Hepatology, King Fahad Hospital, PO Box 1925, Al Madinah Al Munawarah 41441, Saudi Arabia. drkhawaja@yahoo.com
Telephone: +966-4-8461500 Fax: +966-4-8445019
Received: December 25, 2011
Revised: July 15, 2012
Accepted: September 12, 2012
Published online: September 16, 2012
Abstract

Fracture of the central lead wire of an impacted basket during a mechanical lithotripsy for large common bile duct (CBD) stones poses a special challenge. Different maneuvers have been described to resolve this problem. Most techniques require equipment or facilities which may not be readily available in small community hospitals. We present here a similar situation in a patient with a large stone at the level of the cystic duct. Through the duodenoscope, a smaller Dormia basket was introduced into the CBD along the side of the impacted broken basket. The tip of the impacted basket was grasped and, by pulling downwards, the basket was disengaged from the stone. The two baskets were then removed successfully. We suggest this simple technique should be tried initially, before resorting to more advanced procedures.

Keywords: Endoscopic retrograde cholangiopancreatography; Impacted Dormia basket; Mechanical lithotripsy; Fractured Dormia basket