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An 80-year-old man was admitted to the emergency department with fever, jaundice, and abdominal pain due to common bile duct (CBD) lithiasis. His past medical history revealed chronic renal failure and atrial fibrillation, which was treated with warfarin. Therapy with antibiotics and phytomenadione was promptly started, and international normalized ratio values returned to normal. Cholangiography showed the CBD dilated up to 18mm and multiple large stones. Sphincterotomy was performed, followed by papillary pneumatic dilation up to 15mm and stone extraction, with no residual filling defect at cholangiography. E-Videos

Intrabiliary argon plasma coagulation hemostasis by direct cholangioscopy for a tricky post-ERCP bleeding