Therapeutic endoscopic retrograde cholangiopancreatography for giant bile duct stones in a child: A case report

Figure 1 Abdominal ultrasound features of common bile duct stone with obstructive dilatation. A: Dilatation of the intrahepatic bile duct; B: Common bile duct dilatation with echogenicity visible within; C: Pancreatic duct dilatation.

Figure 2 Preoperative abdominal computed tomography findings of common bile duct stones. A: Coronal computed tomography image demonstrating intrahepatic bile duct dilatation; B: Axial computed tomography image showing a calculus within the common bile duct.

Figure 3 Preoperative magnetic resonance cholangiopancreatography findings of biliary-pancreatic duct abnormalities. A: Dilated common bile duct with an intraluminal stone; B: Tortuously dilated main pancreatic duct; C: Pancreatobiliary maljunction; D: Bifurcation of the main pancreatic duct.

Figure 4 Endoscopic retrograde cholangiopancreatography combined with endoscopic sphincterotomy for common bile duct stone extraction. A: Cholangiography stones; B: Duodenal papillotomy; C: Balloon dilatation of the duodenal bulb; D: Common bile duct stones; E: Place a common bile duct stent; F: Paraphiliac ductography with simultaneous visualization of the pancreatic duct and bile duct.

Figure 5 Changes in inflammatory and biochemical markers before and after endoscopic retrograde cholangiopancreatography. WBC: White blood cell; CRP: C-reactive protein; ERCP: Endoscopic retrograde cholangiopancreatography; TBIL: Total bilirubin; ALT: Alanine aminotransferase; GGT: Gamma-glutamyl transpeptidase.

Figure 6 Follow-up abdominal ultrasound findings at 2 weeks post-procedure. A: Significantly reduced diameter of the common bile duct; B: Markedly decreased width of the pancreatic duct.