Successful endoscopic removal of a severed, impacted Dormia basket.

We report the successful removal of a severed and impacted Dormia basket from an elderly patient with choledocholithiasis. One aspect of the case that increased its difficulty is that the basket had become trapped in the bile duct by attaching to an immobile stone that had formed on suture material from a prior biliary operation. Severed baskets that become entrapped in the bile duct are unusual complications of endoscopic bile duct stone removal which used to require surgical intervention. More recent reports suggest that retained baskets can be removed endoscopically in conjunction with some form of lithotripsy. The method used to remove the retained basket in our case involved advancing a Soehendra lithotripter over a looped guidewire after first shrinking the stone with extracorporeal shock wave and laser lithotripsy.