PMC5851175_01
PMC5851175_02
Ampulla prior to cannulation. The biliary orifice (red arrow) and pancreatic orifice (yellow arrow) are seen.
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fig1
The biliary orifice was identified in the superior aspect of the ampulla (Figure 1).
Abdominal radiograph obtained during bedside ERCP showing sphincterotome inside the common bile duct (red arrow). The migrated stent (yellow arrow) is seen with the distal tip inside the bile duct.
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fig2
CBD, and the stent was seen in the proximal bile duct (Figure 2). Contrast injection was not required.
Extension sphincterotomy.
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fig3
An extension sphincterotomy was performed (Figure 3).
Stone extraction.
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fig4
Blind balloon sweeps were performed using a 12 mm balloon-tipped catheter, and several green stones were extracted (Figure 4).
Common bile duct stent placement.
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fig5
CBD without X-ray guidance (Figure 5). Copious bile flow through the stent was observed.
Abdominal radiograph showing appropriate position of the new plastic stent. The old, migrated stent was left inside the bile duct.
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fig6
Appropriate stent placement was confirmed with a repeat abdominal X-ray (Figure 6).