Efficacy of a cholangioscopy-guided basket catheter for removing difficult-to-treat small biliary stones

Abstract

Background: Small stones floating in an enlarged common bile duct can be difficult to remove because of their size and location. This report presents three cases where the SpyGlass™ Retrieval Basket (Boston Scientific Corporation) was effectively used to remove small, difficult-to-treat stones.

Cases 1 and 2: There was difficulty in removing small residual stones after standard procedures in two patients with multiple large common bile duct stones. The SpyGlass™ Retrieval Basket enabled successful and complete removal under direct visualization in both cases.

Case 3: A patient underwent hepaticojejunostomy with a Roux-en-Y construction. Computed tomography revealed intrahepatic bile duct stones. Therefore, single-balloon enteroscopy-assisted direct peroral cholangioscopy was performed. Electrohydraulic lithotripsy fragmented the stones, followed by successful removal using the SpyGlass™ Retrieval Basket.

Conclusion: A cholangioscopy-guided basket catheter may be an option for treatment success patients with difficult-to-treat small biliary stones.