New wire-guided basket for intrahepatic stone extraction

Background:  Endoscopic extraction of intrahepatic ductal stones with conventional stone retrieval baskets sometimes is difficult when the stones are deep in the segmental ducts or in a tortuous duct. We evaluated the use of a new wire-guided basket for endoscopic bile duct stone extraction. Methods:  The new wire-guided basket has a separate lumen for the guidewire on one side of the catheter. It is rail-loaded and advanced over a guidewire into the desired segmental duct. After they are engaged, the stones are dragged into the duodenum and the guidewire is left in the segmental duct. The basket then can be reinserted into that particular ductal segment over the wire for further stone extraction. Results:  The basket was used to treat three patients. Two patients had multiple intrahepatic stones. Repeated passage of the basket back to the desired location was accomplished without difficulty. All stones were removed successfully. Conclusion:  The new wire-guided basket is a useful device for removing intrahepatic stones, particularly from patients with multiple ductal stones.