PMC6465713_01
Endoscopic retrograde cholangiopancreatogram on the first day of hospitalization. There is no string or stent at the major duodenal papilla (a). The X-ray shows the stent remaining in the bile duct, and a stick-like stone has formed around the stent (b, arrow).
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F1
As the endoscope was inserted, it became clear that there was no string at the major duodenal papilla, and the SSC was completely embedded into the bile duct (Fig. 1a, b).
These images show a comparison between placement of the new plastic stent (PS) (a, arrow) and the same PS 2 days later (b, arrow). The newly added PS has straightened the bile duct, and the lower end of the stent-stone complex is separated from the bile duct wall.
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F2
The new PS that had been inserted previously straightened the biliary axis (Fig. 2a, b); thus, we were able to directly insert the grasping forceps into the bile duct, grasp the lower edge of the SSC, and easily remove it with the stent by pulling it out via the endoscope (Fig. 3a, b).