Dormia Baskets Impacted in the Bile Duct: Release by Extracorporeal Shock-Wave Lithotripsy

Abstract

Shock-wave therapy represents a primary nonsurgical therapeutic option in patients with either impacted Dormia baskets or broken devices which cannot be extracted by endoscopic means.

Large-balloon dilation of the biliary orifice for the management of basket impaction: a case series of 6 patients

“…Although the incidence of a basket impaction with an entrapped stone was reported in 5.9% patients 7,13 ; because of the developments in the therapeutic techniques for CBD stones, this incidence has been decreased to 0.8%, 14 comparable to the rate observed in our case series (0.65%). Despite its low incidence, impaction of a basket with an entrapped stone in the distal CBD may cause cholestatic jaundice accompanied by acute suppurative cholangitis, acute pancreatitis, sepsis, 15 and even death, particularly in patients with comorbid diseases, thereby usually requiring open surgery or specialized endoscopic interventions.…”

“…Despite its low incidence, impaction of a basket with an entrapped stone in the distal CBD may cause cholestatic jaundice accompanied by acute suppurative cholangitis, acute pancreatitis, sepsis, 15 and even death, particularly in patients with comorbid diseases, thereby usually requiring open surgery or specialized endoscopic interventions. [7][8][9][10][11][12] However, some of those "rescue" procedures are not widely available in many parts of the world, and most require considerable expertise to achieve a successful outcome. Moreover, as in our case series, patients with severe comorbid diseases are considered at a high risk of open surgery.…”

“…Reported management strategies include the use of a mechanical lithotriptor to capture the impacted basket and crush the stone, extracorporeal shock-wave lithotripsy, endoscopic laser lithotripsy, or other sophisticated methods. [7][8][9][10][11][12] This case series describes, for the first time, the safe and effective use of large-diameter balloon dilation of the biliary orifice in the management of impacted baskets in the distal CBD. consecutive patients with basket impaction in the distal CBD were treated with large-diameter balloon dilation of the postsphincterotomy papilla and subsequent retrieval of the impacted basket and entrapped stone.…”

Endoscopic Retrograde Cholangiopancreatography for the Management of Common Bile Duct Stones and Gallstone Pancreatitis

“…12 A unique indication for ESWL stems from reports of its efficacy as a rescue intervention for stones impacted within the bile duct within basket devices ("impacted basket") after fragmentation of traction wires or failed lithotripsy; however, EHL has also been described for this purpose with case reports of technical success. 50,63 CHOLANGIOSCOPY Per-oral cholangioscopy was first reported in 1977 and is now the preferred technique for therapy of complicated biliary stone disease that requires direct visualization of the biliary system (ie, EHL, ILL). 64 Cholangioscopy platforms have evolved through multiple iterations.…”

Rare and underappreciated complications of endoscopic retrograde cholangiopancreatography

“…ESWL was effective in 12 patients with common bile duct stones 1-2.5 cm in size having impacted (n ¼ 5) or broken (n ¼ 7) baskets. Only 1 session was required in 11 of 12 patients to retrieve the basket and stone(s) [42]. In another case report, directing ESWL toward the trapped basket resulted in successful retrieval of the basket and dissolution of the stone [43].…”