Successful lithotripsy by double-balloon endoscopic retrograde cholangiography for treatment of hepatolithiasis associated with coils

Abstract

A 59-year-old woman was referred for endoscopic treatment of hepatolithiasis after living donor liver transplantation (LDLT) with Roux-en-Y hepaticojejunostomy. She underwent LDLT for liver cirrhosis B at 46 years of age, and liver biopsy 6 months later. Unfortunately, the liver biopsy resulted in biliary hemorrhage with formation of hepatic pseudoaneurysm. Treatment using transcatheter arterial embolization (TAE) with multiple coils was successful. However, the patient suffered from recurrent cholangitis with hepatolithiasis 12 years after LDLT. Double-balloon endoscopic retrograde cholangiography (DBERC) was performed to treat the hepatolithiasis at our hospital. Cholangiography revealed movable hepatolithiasis with the coils. We successfully retrieved the stones without complication using a basket catheter. The stones contained the coils used for TAE. This case is the first report of successful DBERC treatment for hepatolithiasis formed on migrated TAE coils.