A 72-year-old man with a fever was admitted to our hospital. He was initially diagnosed with cholangitis in the common bile duct. We attempted to remove the stone by using conventional endoscopic retrograde cholangiography (ERC) , but the stone could not be moved by any type of catheter. ERC revealed that the stone was incarcerated in the part of communication of three ducts. We found it difficult to remove the stone through conventional way. Therefore, we decided to use the Spyglass DS and electrohydraulic lithotripsy (EHL) . Using these methods, we were able to clearly visualize the stone and break it into pieces. The patient developed mild cholangitis after the treatment, but recovered with antibiotics. Spyglass DS is useful for cases involving difficult bile duct stones.
