impaction of retrieval basket in common bile duct during sphincterotomy and stone retraction

one of the routine methods for diagnosis and treatment of cholelithiasis is endoscopic retrograde cholangiopancreatography. it is an effective method but is associated with some complications (9.8%) which the most common is pancreatitis (5.4%). one of the rare complications is basket impaction in the common bile duct which is treated with different methods. a 58 years male history of laparoscopic cholecystectomy was referred for endoscopic retrograde cholangiopancreatography. during the extraction of stones, the basket was impacted and the distal part was dissociated from the proximal part. stent was placed in the common bile duct and with laparatomy and choleducotomy, bascket with stent and remained stone were extracted and choleducoduodenostomy was done. there are several suggested methods for basket removal; as stenting to relieve the obstruction and possibly allow for spontaneous passage of the impacted stone and basket, endoscopic lithotripsy by percutaneous transhepatic approach, extracorporeal shockwaves to fragment an ampullary impaction, laparoscopic exploration, stone dissolution and surgical intervention. treatment must be tailored to the patient's clinical situation and condition, and the modalities that are accessible. â  â