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. 2019 Jan 8;4(2):72-75.
doi: 10.1016/j.vgie.2018.09.016. eCollection 2019 Feb.

Recalcitrant embedded biliary self-expanding metal stents: a novel technique for endoscopic extraction

Marc Bernon  1 , Christo Kloppers  1 , Jessica Lindemann  1   2 , Jake E J Krige  1 , Eduard Jonas  1
Affiliations

Recalcitrant embedded biliary self-expanding metal stents: a novel technique for endoscopic extraction

Marc Bernon et al. VideoGIE. .
No abstract available

Keywords: ERC, endoscopic retrograde cholangioscopy; SEMSs, self-expanding metal stents; cSEMSs, covered SEMSs; uSEMSs, uncovered SEMSs.

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Figures

Figure 1
Figure 1
Coronal CT image from the portal venous phase, performed at admission, showing a diffusely abnormal-appearing gallbladder with wall thickening and a soft-tissue mass in the central hilar region associated with intrahepatic bile duct dilatation.
Figure 2
Figure 2
MRCP at initial presentation demonstrating a 2-cm stricture in the common hepatic duct with bilateral intrahepatic biliary dilatation.
Figure 3
Figure 3
Coronal image from 5-minute delayed-phase magnetic resonance imaging 5 weeks after presentation showing nearly complete resolution of the previously observed findings.
Figure 4
Figure 4
The distal end of the uncovered SEMS is clearly visible in the duodenum. SEMS, Self-expanding metal stent.
Figure 5
Figure 5
Passage of a guidewire through 2 fenestrations in the uncovered stent, catching the distal end in a loop.
Figure 6
Figure 6
An uncovered SEMS with the positioned guidewire and a Soehendra lithotriptor in place. SEMS, Self-expanding metal stent.
Figure 7
Figure 7
Distortion of distal stent due to snapping of the stent wire through which the guidewire was looped as the wire was pulled into the sheath.
Figure 8
Figure 8
Postprocedure cholangiogram demonstrating an intact and patent biliary tree with air in the extrahepatic bile ducts and left intrahepatic duct.
Figure 9
Figure 9
The right-sided stent is in place with the guidewire within the left duct for subsequent placement of the left-sided stent.
See this image and copyright information in PMC

References

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