The cases of successful endoscopic removal of Type A and Type B stent-stone complex each by peroral cholangioscopy-directed lithotripsy

• Published in: Tando Vol. 35; no. 5; pp. 722 - 730
• Main Authors: Fujita, Yasuaki, Okumura, Fumihiro, Kito, Yusuke, Haneda, Kenichi, Suzuki, Yuta
• Format: Journal Article
• Language: Japanese
• Published: Japan Biliary Association 31.12.2021; 一般社団法人 日本胆道学会
• Subjects: biliary stent; common bile duct stone; electronic hydraulic lithotripsy (EHL); peroral cholangioscopy; stent-stone complex (SSC); stent-stone complex（SSC）; 経口胆道鏡; 総胆管結石; 胆管ステント; 電気水圧衝撃波結石破砕
• ISSN: 0914-0077; 1883-6879
• DOI: 10.11210/tando.35.722

Case1: A 82-year-old man had undergone endoscopic stenting for biliary stenosis caused by autoimmune pancreatitis. At follow-up 51 months after stent placement, Type A stent-stone complex (SSC) was formed around the plastic stent. Since endoscopic choledocholithiasis lithotripsy failed due to impacted stone, we removed the SSC by peroral cholangioscopy-directed lithotripsy (POCSL).Case2: A 87-year-old man had undergone endoscopic stenting for distal bile duct benign stenosis. At follow-up 23 months after stent placement, the Type B stent-stone complex (SSC) was formed into the inward migrated metalic stent. Since the SSC was large and impacted to the bile duct, we crushed the SSC by POCSL and removed the metallic stent.SSC is one of the complications related long term bilialy stent placement, but there are still few reports of SSC. We report two cases, one for each of Type A and Type B SSC, treated by POCSL successfully.