A Case of Successful Endoscopic Extraction of Common Bile Duct Stones After Closing a Duodenal Perforation Using Over-The-Scope Clip

Shinji OE; Shinsuke KUMEI; Tsukasa KARASUYAMA; Nobuhiko SHINOHARA; Kosuke HIDESHIMA; Akitoshi YONEDA; Koichiro MIYAGAWA; Yuichi HONMA; Michihiko SHIBATA; Masaru HARADA

doi:10.7888/juoeh.45.123

Shinji OE , Shinsuke KUMEI, Tsukasa KARASUYAMA, Nobuhiko SHINOHARA, Kosuke HIDESHIMA, Akitoshi YONEDA, Koichiro MIYAGAWA, Yuichi HONMA, Michihiko SHIBATA, Masaru HARADA

Author information

Shinji OE Corresponding author
Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan. Kitakyushu 807-8555, Japan
Shinsuke KUMEI
Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan. Kitakyushu 807-8555, Japan
Tsukasa KARASUYAMA
Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan. Kitakyushu 807-8555, Japan
Nobuhiko SHINOHARA
Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan. Kitakyushu 807-8555, Japan
Kosuke HIDESHIMA
Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan. Kitakyushu 807-8555, Japan
Akitoshi YONEDA
Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan. Kitakyushu 807-8555, Japan
Koichiro MIYAGAWA
Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan. Kitakyushu 807-8555, Japan
Yuichi HONMA
Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan. Kitakyushu 807-8555, Japan
Michihiko SHIBATA
Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan. Kitakyushu 807-8555, Japan
Masaru HARADA
Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan. Kitakyushu 807-8555, Japan

Keywords: CBD stone, endoscopic extraction, ERCP, over-the-scope clip, perforation

JOURNAL FREE ACCESS

2023 Volume 45 Issue 2 Pages 123-127

DOI https://doi.org/10.7888/juoeh.45.123

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Abstract

A 57-year-old man visited our hospital for acute cholangitis due to common bile duct (CBD) stones in March 2021. Biliary stenting was performed without any complications. The cholangitis improved rapidly. He was re-hospitalized to treat the CBD stones in May 2021. Although endoscopic retrograde cholangiopancreatography was performed, endoscopy caused a perforation of the duodenal bulb. We successfully performed endoscopic closure of the duodenal defect using an over-the-scope clip (OTSC^®). Considering that mild CBD dilatation of 10 mm can carry an increased risk of stenosis after surgery, we decided to avoid surgery and perform a follow-up endoscopic treatment. He was re-hospitalized in July 2021. The endoscopy revealed OTSC^® in the anterior wall of the duodenal bulb and complete healing of the perforation. We carefully advanced the scope to the second portion of the duodenum while avoiding OTSC^®, and the ampulla of Vater was identified. We were then able to remove the stones without any complications. OTSC^® was effective in closing a duodenal perforation and enabled us to carry out the retreatment safely and successfully.

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