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commonly used for palliation in patients with obstruction of the bile duct. Extraction of SEMSwhen they become occluded is difficult, sometimes even impossible [1–4]. We describe a new extraction method used in two patients. The firstwas a74-year-oldmanpresenting with jaundice due to pancreatic adenocarcinoma. Endoscopic retrograde cholangiopancreatography (ERCP) showed stenosis of the common bile duct. A partially covered 6-cm SEMS (Taewoong Medical, Seoul, Korea)wasplaced. Tenmonths later the patient presentedwith septic fever but no jaundice. ERCP showed partial occlusion of the SEMS at the proximal noncovered end by ingrowth of tumor tissue (●" Fig. 1). Attempted extraction of the stent with a polypectomy snare (Cook Medical; Cook Ireland Ltd., Limerick, Ireland) failed even using maximum tensile force. Our second patient was a 48-year-old woman with radiological diagnosis (CT, magnetic resonance cholangiopancreatography) of a choledochal cyst. ERCP revealed cystic dilatation of the common bile duct, measuring 7 cm in diameter, and a distal stenosis. A 6-cm SEMS (Taewoong Medical) was placed. On days 64 and 66 after stent placement, extraction of the SEMS was attempted because of occlusion, but failed to be achieved using basket, grasper, or snare. In both cases of unextractable SEMS we performed a new technique: the SEMS was caught with a polypectomy snare (Cook Medical, 15 × 25mm) at the free duodenal end. The endoscope was removed and the metal sheath of the Soehendra emergency lithotripter (Cook Medical) was inserted over the polypectomy snare as it is usually inserted over the Dormia basket in lithotripsy. The mechanical lithotripter was then connected and the hydraulic crank slowly wound, moving the metal sheath forward as a wedge between the common bile duct wall and the SEMS (●" Fig. 2). Extraction of self-expanding metallic common bile duct stents with snare and Soehendra lithotripter