Basketing a basket: A novel emergency rescue technique

Area of Science:

• Gastroenterology
• Endoscopic procedures
• Biliary interventions

Background:

• Mechanical lithotripsy for common bile duct (CBD) stones can lead to basket fragmentation.
• Retrieving fractured basket fragments can be technically demanding.
• Existing retrieval techniques may require specialized equipment not available in all centers.

Purpose of the Study:

• To describe a simple, accessible technique for retrieving a fractured impacted basket during CBD stone lithotripsy.
• To present a case of successful retrieval of a fractured basket engaged with a cystic duct stone.

Main Methods:

• A fractured Dormia basket impacted with a cystic duct stone was encountered.
• A second, smaller Dormia basket was introduced via duodenoscope alongside the impacted basket.
• The fractured basket's tip was grasped, disengaged from the stone, and removed with the second basket.

Main Results:

• The impacted fractured basket was successfully disengaged from the cystic duct stone.
• Both the fractured basket and the retrieval basket were removed without complications.
• The procedure was performed using readily available endoscopic equipment.

Conclusions:

• A simple technique of using a second Dormia basket can effectively retrieve fractured impacted baskets.
• This method offers a low-resource alternative to more complex retrieval procedures.
• This technique should be considered as an initial approach for impacted fractured baskets during lithotripsy.