Laparoscopic common bile duct exploration and retrieval of endoscopic lithotripsy basket after mechanical failure

Abstract

Impaction of a mechanical lithotripsy basket during endoscopic retrograde cholangiopancreatography is a rare but serious complication resulting from technical failure. We describe a novel case of lithotripsy basket retrieval aided by laser fragmentation. This 87-year-old male underwent an emergency laparoscopic subtotal cholecystectomy, common bile duct (CBD) exploration and laser lithotripsy after attempts at endoscopic mechanical lithotripsy caused a stone-basket complex to become impacted within the CBD. In the absence of endoscopic salvage techniques, laparoscopic CBD exploration is a valid and safe option where surgical expertise permits.