Common bile duct exploration for retrieval of impacted Dormia basket following endoscopic retrograde cholangiopancreatography with mechanical failure: Case report

Abstract

Dormia baskets are commonly used during endoscopic retrograde cholangiopancreatography (ERCP). One of the complications is basket retention, through impaction with a gallstone or wire fracture. We describe a case of 45-year-old female, referred from the endoscopy department for an emergency surgery. She was undergone ERCP for obstructive jaundice secondary to choledocholithiasis. She was presented to us with metallic wire seen in her oral cavity as external handle of basket snapped causing retained basket plus large gallstone impacted in common bile duct (CBD). She underwent an emergency laparotomy following CBD exploration for direct stone fragmentation. The basket was cut and removed; wire was withdrawn orally. We describe a case of 45-year-old female, referred from the endoscopy department for an emergency surgery. She was undergone ERCP for obstructive jaundice secondary to choledocholithiasis. She was presented to us with metallic wire seen in her oral cavity as external handle of basket snapped causing retained basket plus large gallstone impacted in CBD. She underwent an emergency laparotomy following CBD exploration for direct stone fragmentation. The basket was cut and removed; wire was withdrawn orally. This case highlights mechanical failure of Dormia basket and its subsequent management which required high surgical skill and full armamentarium in emergent situation for safe and feasible approach which also prevent further interventions.