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DOI: 10.1055/a-2432-3302
Retrieval technique for a sheared guidewire remnant in the gallbladder duct using a novel basket catheter
Endoscopic transpapillary gallbladder drainage (ETGBD) is one of the most difficult endoscopic retrograde cholangiopancreatography (ERCP)-related procedures to perform, as it often causes adverse events in the gallbladder duct [1]. Retrieval is technically difficult if a sheared guidewire remnant remains in the gallbladder duct. Herein, we present a case in which a sheared guidewire remnant was successfully retrieved from the gallbladder duct using a novel basket catheter.
A 78-year-old man was admitted to our hospital with acute cholecystitis ([Fig. 1]). He was promptly treated using antibiotics and ETGBD. While manipulating the guidewire in the gallbladder duct, the guidewire became kinked, broke off, and remained in the duct ([Fig. 2] a, b). We attempted to retrieve the sheared guidewire using a RASEN 2 basket catheter (Kaneka Medical, Osaka, Japan) that was inserted along the guidewire, deployed into the gallbladder duct, and rotated clockwise to confirm that the guidewire remnant was inside ([Fig. 2] c). Once we closed the basket, we were able to firmly grip the guidewire and pull it out of the patient through the channel of the endoscope ([Fig. 2] d, [Fig. 3]).
There have been few reports in the literature concerning techniques for retrieving residual guidewires, mostly using biopsy forceps during endoscopic ultrasound or ERCP [2] [3]. To our knowledge, no studies have yet described remnant guidewire retrieval in the gallbladder duct using a basket catheter. This new type of basket catheter has a unique shape and rotational mechanism that may be useful not only for removing bile duct stones but also for retrieving foreign bodies in narrow areas such as the gallbladder duct ([Video 1]).
Video showing the retrieval of a sheared guidewire remnant in the gallbladder duct using the novel RASEN 2 basket catheter.Video 1Endoscopy_UCTN_Code_TTT_1AR_2AG
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Publication History
Article published online:
08 November 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).
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References
- 1 Nakahara K, Sato J, Morita R. et al. Incidence and management of cystic duct perforation during endoscopic transpapillary gallbladder drainage for acute cholecystitis. Dig Endosc 2022; 34: 207-214
- 2 Hirakawa N, Tonozuka R, Itoi T. Endoscopic retrieval of a sheared guidewire remnant from walled-off necrosis. Dig Endosc 2021; 33: e104-e105
- 3 Hirakawa N, Mukai S, Itoi T. Endoscopic retrieval of a sheared guidewire remnant with microbiopsy forceps from a peripheral intrahepatic bile duct. Dig Endosc 2023; 35: e103-e104