Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Feb 27, 2015; 7(2): 15-20
Published online Feb 27, 2015. doi: 10.4240/wjgs.v7.i2.15
Results of the open surgery after endoscopic basket impaction during ERCP procedure
Sezgin Yilmaz, Ogun Ersen, Taner Ozkececi, Kadir S Turel, Serdar Kokulu, Emre Kacar, Murat Akici, Murat Cilekar, Ozgur Kavak, Yuksel Arikan
Sezgin Yilmaz, Ogun Ersen, Taner Ozkececi, Yuksel Arikan, Department of General Surgery, Kocatepe University, 03020 Afyon, Turkey
Kadir S Turel, Murat Akici, Murat Cilekar, Ozgur Kavak, Department of General Surgery, State Hospital, 03020 Afyon, Turkey
Serdar Kokulu, Department of Anaesthesiology, Kocatepe University, 03020 Afyon, Turkey
Emre Kacar, Department of Radiology, Kocatepe University, 03020 Afyon, Turkey
Author contributions: Yilmaz S contributed to conception and design of the study, acquisition of data, drafting the article and final approval of the version of the article, making revisions and performing the ERCP procedures, carrying out the operations; Ersen O, Turel KS, Akici M, Cilekar M and Kavak O contributed to conception and design of the study, acquisition of data, drafting the article and final approval of the version of the article; Ozkececi T contributed to conception and design of the study, acquisition of data, drafting the article and final approval of the version of the article, performing the ERCP procedures; Kokulu S contributed to conception and design of the study, acquisition of data, drafting the article and final approval of the version of the article, anesthesia protocol and postoperative care; Kacar E contributed to conception and design of the study, acquisition of data, drafting the article and final approval of the version of the article, radiological evaluations; Arikan Y contributed to conception and design of the study, acquisition of data, drafting the article and final approval of the version of the article, performing the ERCP procedures, carrying out the operations and final revision of the manuscript.
Ethics approval: The study was reviewed and approved by the Afyon Kocatepe University, The Ethical Committee of Medical Faculty.
Informed consent: All the patients in the study gave written informed consent prior to study enrollment.
Conflict-of-interest: The authors declare that they have no conflict of interest.
Data sharing: Technical appendix, statistical code and dataset are available from the corresponding author (SY, drsezginyilmaz@gmail.com).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sezgin Yilmaz, MD, Department of General Surgery, Kocatepe University, Gazligöl Yolu, Ahmet Necdet Sezer Kampusü, Gazlıgöl Yolu, 03020 Afyon, Turkey. drsezginyilmaz@gmail.com
Telephone: +90-505-5786290
Received: September 1, 2014
Peer-review started: September 2, 2014
First decision: November 27, 2014
Revised: December 6, 2014
Accepted: January 9, 2015
Article in press: January 12, 2015
Published online: February 27, 2015
Processing time: 162 Days and 22.4 Hours
Abstract

AIM: To report the results of open surgery for patients with basket impaction during endoscopic retrograde cholangiopancreatography (ERCP) procedure.

METHODS: Basket impaction of either classical Dormia basket or mechanical lithotripter basket with an entrapped stone occurred in six patients. These patients were immediately operated for removal of stone(s) and impacted basket. The postoperative course, length of hospital stay, diameter of the stone, complication and the surgical procedure of the patients were reported retrospectively.

RESULTS: Six patients (M/F, 0/6) were operated due to impacted basket during ERCP procedure. The mean age of the patients was 64.33 ± 14.41 years. In all cases the surgery was performed immediately after the failed ERCP procedure by making a right subcostal incision. The baskets containing the stone were removed through longitudinal choledochotomy with the stone. The choledochotomy incisions were closed by primary closure in four patients and T tube placement in two patients. All patients were also performed cholecystectomy additionally since they had cholelithiasis. In patients with T-tube placement it was removed on the 13th day after a normal T-tube cholangiogram. The patients remained stable at postoperative period and discharged without any complication at median 7 d.

CONCLUSION: Open surgical procedures can be applied in patients with basket impaction during ERCP procedure in selected cases.

Keywords: Biliary stone; Endoscopic retrograde cholangiopancreatography; Basket; Impaction; Surgery

Core tip: The impaction or wire fracture of basket is an uncommon but potentially highly dangerous complication during endoscopic retrograde cholangiopancreatography and stone extraction. Although there are several endoscopic approaches to treat the basket impaction they require specialized equipments and experienced clinicians. So surgical approach can be an alternative to endoscopic procedures in selected patients.