SpyGlass Retrieval Snare
Atlantic Digestive Specialists
Somersworth, NH USA
A sphincterotome loaded with a .025” Jagwire™ Revolution High Performance Guidewire was used to cannulate the common bile duct. A cholangiogram was performed and revealed a narrow stricture in the right hepatic duct and branches of the right hepatic ducts. Above one of these strictures, a fragment of a plastic biliary stent could be seen under fluoroscopy. The strictures downstream from this foreign body was dilated using a combination of balloon dilation and rigid dilation. Unsuccessful attempts were made to sweep the stent fragment using an Extractor Pro XL balloon and a Trapezoid Basket. Dr. Ruben decided to use the SpyGlass DS System’s cholangioscope. The SpyScope™ DS II was advanced into position through both strictures that had been dilated where the stent fragment could be visualized. A SpyGlass Retrieval Snare was then passed through the SpyScope DS II, opened, and secured around the stent fragment. The SpyScope along with the snare and stent fragment were then removed from the bile duct.
Dr. Ruben successfully removed the stent fragment using the SpyScope DS II and SpyGlass Retrieval Snare. It is assumed that one of the strictures that was distal to the stent fragment may have caused thestent to break when the stent was removed during previous ERCP. Once the stent fragment was removed is was shown under fluoroscopy that contrast was draining normally and the previously strictured duct showed patency.
The SpyGlass Retrieval Snare provided a way to remove the stent fragment from the right hepatic system. The use of the SpyScope DS II and SpyGlass Retrieval Snare may have helped the patient avoid a repeat procedure or any surgical intervention and may be considered as an option for the removal of a foreign body in the pancreaticobiliary system going forward.