Two-step EUS-guided antegrade treatment of a difficult bile duct stone in a surgically altered anatomy patient

Abstract

EUS-guided antegrade (EUS-AG) treatment is a treatment option for bile duct stones (BDS) in surgically altered anatomy patients[1, 2] but can be technically demanding due to the limitation of stone extraction devices[3, 4]. Herein, we presented a case of a difficult BDS successfully removed by two-step EUS-AG treatment after enterobiliary fistula maturation.A 73 year-old male with a history of gastrectomy and Roux-en-Y reconstruction for gastric cancer presented with 12-mm BDS on CT scan (Figure1).

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