Basket Case: Fluoroscopy-Free Capture and Retrieval of Biliary and Pancreatic Duct Stones
Stanford Multidisciplinary Seminars
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Case Presentations and Evolution
A 72-year-old woman was evaluated for severe epigastric pain associated with nausea and diaphoresis. Her past medical history was significant for cholecystectomy 3 years previously and multiple endoscopic retrograde cholangiopancreatography (ERCP) procedures for the management of recurrent choledocholithiasis. Vital signs were notable for a heart rate of 79 beats/min, temperature of 37.1 °C, blood pressure of 96/69 mm of Hg, and respiratory rate of 16/min. Physical examination revealed mild right upper quadrant tenderness, without other abnormality. Laboratory studies included normal total bilirubin (0.7 mg/dL), AST 48 U/L (normal < 40), ALT 59 U/L (normal < 60), and alkaline phosphatase 179 U/L (normal 40–130). Imaging with magnetic resonance cholangiopancreatography again indicated choledocholithiasis, with marked dilation of the common bile duct to 2.4 cm. ERCP performed with anesthesia support revealed a large peri-ampullary diverticulum, a...
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Conflict of interest
None of the authors have any conflicts of interest pertaining to the study to disclose.
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