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Case Reports in Gastrointestinal Medicine
Volume 2012 (2012), Article ID 435050, 3 pages
http://dx.doi.org/10.1155/2012/435050
Case Report

A Novel Two-Step Approach for Retrieval of an Impacted Biliary Extraction Basket

Division of Gastroenterology, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada V5Z 1M9

Received 3 May 2012; Accepted 24 July 2012

Academic Editors: I. M. Leitman and Ö. Yönem

Copyright © 2012 Calvin H. Y. Chan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Biliary extraction baskets are a commonly used instrument for the removal of choledocholithiasis in endoscopic retrograde cholangiopancreatography (ERCP). Impaction of the extraction basket is a recognized complication of ERCP, and is usually the result of discrepancy between the size of bile duct stone and the diameter of the distal bile duct. Whilst mechanical lithotriptors can be used to crush the stone or break the wires of the basket to allow its release, failure of the lithotriptor device can occur. We describe the case of a 59-year-old gentleman who had an ERCP performed for choledocholithiasis. Basket impaction was encountered, and the mechanical lithotriptor failed to dislodge the stone/basket complex. A two-step technique involving balloon dilatation and forceps manipulation of the basket was applied to successfully dislodge the impacted basket. We believe this simple and safe technique should be adopted to rescue impacted biliary extraction baskets to avoid the need for potential surgical removal.