This 40 year old lady had been referred to our centre with a post cholecystectomy biliary stricture five months ago. A single 10 French plastic stent of 12 cm length was placed. She was then reviewed two months later (3 months ago) whereby the single stent was removed and two 10 French plastic stents were passed http://ercp365.blogspot.com/2013/09/post-cholecystectomy-cbd-stricture.html. At that time, the sheath of our guidewire had broken and left in the upper CBD. We had hoped to remove both stents and discharge the patient. On endoscopy, both stents were seen (A: white arrows). One stent was removed with a snare which also resulted in the removal of guidewire sheath left inside three months earlier (B: Red arrow indicates the piece of guidewire sheath. Blue arrow shows the second stent. D: white arrow indicates the piece of guidewire sheath in the intestinal lumen as seen on fluoroscopy. E: The broken sheath after retrieval with forceps). The second stent was also removed using the snare (C: blue arrow). Contrast injection after stent removal showed some persistence of the stricture (F: white arrow) which was dilated with a 10mm diameter TTS balloon (G: white arrow). We then passed a single 12cm long 10 French plastic stent (H: white arrows) and scheduled a repeat appointment after eight weeks.
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