Treatment of common bile duct stones with a forward-viewing scope in a patient with severe esophageal hiatal hernia

Abstract

An 80-year-old woman was hospitalized for acute cholangitis due to common bile duct stones. Abdominal computed tomography revealed a high degree of esophageal hiatal hernia. Endoscopic retrograde cholangiopancreatography (ERCP) with a JF-260V esophagogastroduodenoscope was attempted, but we were not able to insert the scope into the duodenum. By replacing it with the GIF-Q260J forward-viewing scope, it became possible to insert it into the duodenum and ERCP was performed. A 7 Fr double pigtail-type bile duct stent was placed. Nine days later, a second ERCP was performed with the GIF-Q260J and the bile duct stones were removed. She was discharged without postoperative complications. In cases of severe esophageal hiatal hernia, treatment with a direct endoscope may be an option.