A Case of an Incarcerated Confluence Stone Removed Completely by Using Spyglass DS-guided Electrohydraulic Lithotripsy (EHL)

We report a case of a 59-year-old man with an incarcerated confluence stone who was admitted in our hospital. At first, we diagonosed that he had cholangitis with a common bile duct (CBD) stone by CT scan and MRI. Then, we performed endoscopic retrograde cholangiography (ERC) to remove the CBD stone. But, we couldn't remove the CBD stone because it was an incarcerated in the part of communication of three ducts. We failed two times to remove the incarcerated confluence stone by using standard basket or balloon extraction, endoscopic mechanical lithotripsy (EML). So, we decide to use the Spyglass DS-guided EHL. Fainally, we were able to visualize the confluence stone and break it into pieces. Spyglass DS System can be considered useful and effective for removal of confluence stones.