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Endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard procedure for the treatment of bile duct stones, and most stones are successfully removed with accessories such as biliary baskets or extraction balloons. Impaction of a biliary basket is not an uncommon complication of this procedure, being reported in 0.8%–5.9% of cases. Mechanical lithotripsy usually solves the problem by crushing the stone, followed by extraction of the stone fragments. However, on rare occasions, fracture of the basket occurs during mechanical lithotripsy, and this can pose a special management problem, depending on where the breakage occurs [1–3]. We report the successful management of an impacted biliary basket after breakage of the basket handle cord during extra-endoscopic mechanical lithotripsy. A 35-year-old man, who had undergone early laparoscopic cholecystectomy in a small regional hospital 1 month before, presented with jaundice and upper right quadrant pain on admission. Laboratory tests revealed obstructive jaundice with raised γ-glutamyl transpeptidase (γGT) and alkaline phosphatase (ALP) and a total bilirubin concentration of 11.11mg/ dL. Apart from a mildly dilated common bile duct (CBD) with stones, computed tomography of the abdomen revealed no E-Videos

Broken handle cord of impacted biliary basket – rescue by cholangioscopy with laser lithotripsy