A case of hepatolithiasis successfully treated by new basket catheter

Abstract

A 70-year-old man was present with fever, chills and jaundice. Abdominal enhanced computed tomography (CT) showed hepatolithiasis of right hepatic lobe and common bile duct (CBD) stones. On endoscopic retrograde cholangiography, we successfully extracted CBD stones. However, intrahepatic stones of the posterior segment branches (B6) were left since conventional basket catheter could not pass. After several days, we succeeded to advance COAXIS deeply and extract residual stones of B6 without complications. Conventional basket catheter has the sideslit for the guidewire at the outside of the catheter. On the other hand, COAXIS has it at the center of the catheter, which achieves high followability to the guidewire. COAXIS might be useful for all the peripheral bile ducts that have been recognized difficult to be approached with the conventional basket catheters.