1 | INTRODUCTION
Common bile duct (CBD) stones are, generally, a risk factor for
cholangitis and therefore, should be removed. Surgical lithotomy or
endoscopic lithotomy is the preferred treatment modality to treat CBD
stones. Owing to its minimally invasive nature, endoscopic lithotomy has
become the first choice of treatment.
CBD stones may prove challenging to remove by endoscopic lithotomy,
especially in patients with a very large stone size, multiple stones
packed closely,1-5 a
history of digestive tract
reconstruction,6,7or a combination of these factors. In addition to the above mentioned
factors, the presence of a CBD stricture also increases the difficulty
of endoscopic
lithotomy.8-10 If a
distal CBD stricture is narrower than the diameter of the CBD stones,
removing the stones becomes further complicated.
Herein, we report a case in which the CBD stones were difficult to
remove due to a CBD stricture caused by chronic pancreatitis (CP) and
therefore; were also difficult to treat by endoscopic lithotripsy.
However, these stones were spontaneously removed using a covered
self-expanding metallic stent (CSEMS).