2025 Volume 67 Issue 5 Pages 1076-1082
The patient was a 28-year-old man who underwent 24Fr gastrostomy and tracheostomy for amyotrophic lateral sclerosis and was hospitalized for acute cholangitis. Although CT and magnetic resonance cholangiopancreatography showed no bile duct stones, recurrent episodes persisted. Insertion of the therapeutic duodenoscope into the esophagus was unsuccessful. To address the recurrent cholangitis after laparoscopic cholecystectomy for cholecystolithiasis, a 5Fr biliary stent was placed via gastrostomy using an ultrathin endoscope. Despite regular stent replacement, acute cholangitis due to migrated biliary stent recurred. We planned stomal dilation, which successfully allowed the insertion of the duodenoscope. After stent removal, sphincterotomy and removal of tiny bile stones were performed without any complications. The patient showed no recurrence after treatment.
