A 75-year-old man who had undergone pancreaticoduodenectomy was admitted for postprandial epicardial pain. Computed tomography revealed an intrahepatic calculus near the site of choledochojejunostomy with intrahepatic bile duct dilation. A short-type single-balloon enteroscope was inserted to the choledochojejunostomy site. After dilating the anastomosis with a 10 mm balloon, the enteroscope was removed, leaving the overtube. An ultra-thin endoscope was inserted through the overtube, was directly advanced into the bile duct, and confirmed the presence of bile duct stone. After electrohydraulic lithotripsy (EHL) was performed, complete stone extraction was performed using the short-type single-balloon enteroscope. The patient was discharged from the hospital with good prognosis and without adverse events. By using the ultra-thin endoscope, a good field of view was secured and EHL could be smoothly performed.
