• Ufuk Arslan, Haci Murat Cayci, Ali Tardu, and Umut Eren Erdogdu.
• Department of General Surgery, University of Medical Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.
• J Coll Physicians Surg Pak. 2020 Apr 1; 30 (4): 435-437.

AbstractEndoscopic retrograde cholangiopancreatography may fail to extract large and multiple choledochal stones in a single session, necessitating a repeat procedure. This paper presents the case of a 68-year female patient who underwent stone extraction following endoscopic retrograde cholangiopancreatography and a subsequent biliary stenting procedure for multiple choledochal stones. Cholelithiasis and choledocholithiasis were detected in the above patient presenting with abdominal pain and jaundice. Conventional endoscopic retrograde cholangiopancreatography techniques failed to extract the stones, and the patient subsequently underwent a sequential insertion of multiple biliary stents. The procedure was used to facilitate the downsizing and fragmentation of the stones. The duct was then cleared using the balloon/basket technique. No problem occurred within the follow-up period and the patient underwent a successful cholecystectomy four weeks after the procedure. Multiple stenting is one treatment method that can be performed in selected patients with large and multiple choledochal stones.   Key Words: Choledocholithiasis, Endoscopic retrograde cholangiopancreatography (ERCP), Biliary stenting.

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