Korean J Radiol.  2011 Apr;12(2):247-251. 10.3348/kjr.2011.12.2.247.

Percutaneous Transhepatic Release of an Impacted Lithotripter Basket and Its Fractured Traction Wire Using a Goose-Neck Snare: a Case Report

• Kwon JH
• Lee JK
• Lee JH
• Lee YS

• KMID: 1088571
• DOI: http://doi.org/10.3348/kjr.2011.12.2.247

Abstract

In a patient with a distal common bile duct stone, a fracture of the traction wire of the basket occurring during the performance of mechanical lithotripsy resulted in the impaction of the lithotripter basket with a stone. The impacted lithotripter basket combined with a fracture of the traction wire is a rare complication of endoscopic stone removal. We were able to pull the impacted basket using an Amplatz goose-neck snare inserted via the percutaneous transhepatic route, which resulted in the freeing of the entrapped stone into the dilated supra-ampullary bile duct. The fractured traction wire and basket could be safely removed by pulling the traction wire from the mouth. The present report is the first to describe the safe and effective use of an Amplatz goose-neck snare for the management of a lithotripter basket impacted with a stone and a fractured traction wire.

Keyword

Lithotripsy; Impacted basket; Percutaneous; Goose neck snare

MeSH Terms

Aged
Cholangiopancreatography, Endoscopic Retrograde
Device Removal/*methods
Diagnosis, Differential
Equipment Failure
Gallstones/radiography/*therapy
Humans
Lithotripsy/*instrumentation
Male
Radiography, Interventional
Tomography, X-Ray Computed
Traction/instrumentation

Figure

• 

  Fig. 1 Percutaneous transhepatic release of impacted lithotriptor basket and its fractured traction wire in 66-year-old male with common bile duct stone. A. Fluoroscopy of abdomen shows impacted Dormia basket (black arrow) and its fractured traction wire (white arrow) in distal common bile duct. B. Fluoroscopy shows Amplatz goose-neck snare caught proximal portion of impacted Dormia basket. C. Fluoroscopy shows impacted Dormia basket that was pulled into proximal portion of bile duct by Amplatz goose-neck snare. D. Impacted Dormia basket and fractured traction wire were removed from mouth. Pig tail catheter was kept in place for biliary drainage (arrow). Large biliary stone is seen in distal common bile duct (curved arrow).

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