Khawaja Fazal Imtiaz, Ahmad Mohammed Mushtaque
Fazal Imtiaz Khawaja, Mohammed Mushtaque Ahmad, Department of Gastroenterology and Hepatology, King Fahad Hospital, Al-Madinah Al-Munwarah 41441, Saudi Arabia.
World J Gastrointest Endosc. 2012 Sep 16;4(9):429-31. doi: 10.4253/wjge.v4.i9.429.
Fracture of the central lead wire of an impacted basket during a mechanical lithotripsy for large common bile duct (CBD) stones poses a special challenge. Different maneuvers have been described to resolve this problem. Most techniques require equipment or facilities which may not be readily available in small community hospitals. We present here a similar situation in a patient with a large stone at the level of the cystic duct. Through the duodenoscope, a smaller Dormia basket was introduced into the CBD along the side of the impacted broken basket. The tip of the impacted basket was grasped and, by pulling downwards, the basket was disengaged from the stone. The two baskets were then removed successfully. We suggest this simple technique should be tried initially, before resorting to more advanced procedures.
在对大的胆总管结石进行机械碎石术时，嵌顿篮的中心导丝断裂是一个特殊的挑战。已有多种不同的操作方法来解决这一问题。大多数技术需要的设备或设施在小型社区医院可能并不容易获得。我们在此介绍一位在胆囊管水平有大结石患者的类似情况。通过十二指肠镜，将一个较小的多尔米亚篮沿着嵌顿破碎篮的一侧插入胆总管。抓住嵌顿篮的尖端，向下拉，使篮子与结石分离。然后成功取出两个篮子。我们建议在采用更先进的手术之前，应首先尝试这种简单的技术。
