Digital single-operator cholangioscopy with EHL as salvage therapy of an internalized and stone-impacted biliary stent 13 years after implantation

We report the case of a 72-year-old patient who presented with an inadvertently remaining CBD stent that was completely internalized and heavily impacted by biliary concretions over its entire length 13 years after implantation. Following an unsuccessful conservative ERC salvage attempt, digital single-operator cholangioscopy (dSOC) in combination with electrohydraulic lithotripsy (EHL) was used to fragment the biliary concrements. Finally, after endoscopic papillary balloon dilatation up to 12 mm and removal of the fragmented concretions, the stent was successfully retrieved into the duodenum.

The development of technically advanced tools such as dSOC and dedicated instruments, including the SpyGlass Retrieval Snare and Retrieval Basket, have enabled removal of inadvertently proximally dislocated CBD stents. Our case shows that dSOC in combination with its instruments, such as EHL, is an effective and safe therapeutic option, even in special and rare cases such as this one, in which a stent was dislocated proximally and had become completely impacted by stones after 13 years.

Publikationsverlauf

Artikel online veröffentlicht:
14. März 2022

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