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Okano et al. Mini-invasive Surg 2021;5:29 https://dx.doi.org/10.20517/2574-1225.2021.15 Page 7 of 9
Figure 5. A bile duct plastic stent migrated into the bile duct. A contrast-enhanced cannula was guided under fluoroscopic guidance to
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the distal end of the plastic stent, and then a guide wire passed through the inside of the plastic stent. A Soehendra Stent Retriever was
covered over the guide wire and guided under fluoroscopic guidance, the end locked onto the stent, and then withdrawn to the
duodenum under fluoroscopic guidance.
Figure 6. Although mechanical lithotripsy was attempted on a giant stone, the stone was hard and damaged the wire, and the basket
was impacted. The impaction was released using an endotripter, and a tube stent was placed.
If the methods described above fail, then the impaction can be released by crushing the stone with
extracorporeal shock wave lithotripsy or with electrohydraulic lithotripsy under peroral cholangioscopy.
