[ERCP without fluoroscopy in a pregnant woman with a common bile duct stone].

pattern. She was in her 23rd week of pregnancy. Amagnetic resonance cholangiopancreatography (MRCP) was performed. Cholecystolithiasis and a common bile duct stone were observed (Fig. 1). Endoscopic retrograde cholangiopancreatography (ERCP) was deemed to be the treatment of choice. The patient was informed that as little radiation as possible would be used. However, as she was in her second trimester of pregnancy, there was a reduced possibility of teratogenicity with a short radiation time. As in this gestational stage the abdomen is already distended, the ERCP procedure was performed with the patient lying on her left side. A lead apron was used to cover the patient’s abdomen. A tapered sphincterotome loaded with a 0.025 inch guidewire was used for common bile duct cannulation (Autotome, Rapid Exchange System). Once the sphincterotome had entered the ampulla, in the theoretically common bile duct position, the guidewire was pushed and advanced freely. Afterwards, the sphicterotome was passed after the guidewire, and bile juice was aspirated to assess a correct bile duct position. The guidewire was secured not to lose biliary cannulation. The sphincterotome was squeezed and Vater’s papilla was cut (Fig. 2). Subsequently, the sphincterotome was withdrawn, leaving always the ERCP without fluoroscopy in a pregnant woman with a common bile duct stone