Endoscopic removal of impacted Dormia basket: The post-cut procedure

Abstract

Endoscopic procedures are widely used for the management of bile duct stones. Pancreatitis, haemorrhage, cholangitis and intestinal perforation are the most commonly reported complications. Impaction of stone-retrieving devices such as Dormia basket is rare. It can be removed using a smaller basket, balloons, percutaneous transhepatic removal, laparoscopic retrieval or even through laparotomy. In our case, it was feasible and safe using the post cut technique which is a type of a second biliary sphincterotomy performed after a previous sphincterotomy in order to enlarge the papillary orifice and to extract the impacted Dormia basket. *Correspondence to: Wael Ferjaoui, Department of Surgery B23, Charles Nicolle Hospital, Tunisia, Tel: +216 52430099; E-mail: farjaouiwael4@gmail.com key words: common bile duct stone, impacted Dormia basket, post cut Received: July 15, 2019; Accepted: August 01, 2019; Published: August 05, 2019 Introduction Endoscopic management is the first line therapy of common bile duct stones [1]. In most cases, they are successfully extracted with Endoscopic Retrograde Cholangiopancreatography (ERCP) and endoscopic sphincterotomy (ES) using a Dormia basket or balloon catheters [1]. This endoscopic treatment ensures less morbidity and mortality then surgery [1]. The most common complications of endoscopic treatment are pancreatitis, bleeding and perforation [2]. Recognizing other less common events like Dormia basket impaction is important in order to prevent disastrous outcomes. The aim of this article is to report a case of Dormia basket impaction that could be managed using an endoscopic technique called the post-cut procedure in order to prove its efficiency and safety.