Case Report
Copyright ©2009 Baishideng. All rights reserved.
World J Gastrointest Surg. Nov 30, 2009; 1(1): 59-61
Published online Nov 30, 2009. doi: 10.4240/wjgs.v1.i1.59
Peroral cholangioscopy-assisted guidewire placement for removal of impacted stones in the cystic duct remnant
Mansour A Parsi
Mansour A Parsi, Center for Endoscopy and Pancreatobiliary Disorders, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United States
Author contributions: Parsi MA contributed entirely to this case report.
Correspondence to: Mansour A Parsi, MD, Center for Endoscopy and Pancreatobiliary Disorders, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United States. parsim@ccf.org
Telephone: +1-216-4454880 Fax: +1-216-4446284
Received: May 27, 2009
Revised: July 19, 2009
Accepted: July 26, 2009
Published online: November 30, 2009
Abstract

It is well known that impacted biliary stones are difficult to remove endoscopically. Among the many factors associated with failure of endoscopic therapy for removal of bile duct stones, impaction ranks high. One of the reasons behind failure of endoscopic therapy in such cases is that the impacted stone often does not allow passage of a guidewire. Recent introduction of a novel single-operator cholangioscopy system has made it possible for a single endoscopist to use cholangioscopy for evaluation and treatment of a wide variety of biliary disorders. This cholangioscopy system was used for placement of a guidewire in the cystic duct remnant with subsequent removal of an impacted stone which had prevented passage of a guidewire by conventional means.

Keywords: Endoscopic retrograde cholangiopancreatography; Cholangioscopy; Guidewire; Choledocholithiasis; Cystic duct; Cystic duct remnant