Endoscopic Troubleshooting for Acute Cholecystitis With a Stone Impacted in the Cystic Duct

Abstract

Endoscopic transpapillary gallbladder drainage is considered an alternative procedure in patients with acute cholecystitis who are not surgical candidates; however, it remains challenging, especially in cases with a stone impacted into the cystic duct (CD). In cases in which a stone is impacted at the CD orifice, a cholangioscope and forceps may be used to release the stone. In cases in which the stone is impacted in the middle of the CD, contrast pressure from above the injection retrieval balloon may be used to push the stone toward the gallbladder. We believe this is the first report of such cases in the literature.