Endoscopic lithotripsy for an impacted biliary stone at the confluence of the cystic duct and common bile duct using a novel drill dilator

Endoscopic retrograde cholangiopancreatography (ERCP) is widely performed for patients with common bile duct (CBD) stones. Many cases are successfully managed with endoscopic sphincterotomy and stone removal using balloon or basket catheters. However, for difficult or complex stones, ERCP with conventional techniques may fail to achieve biliary clearance in 10–15% of cases [1]. Peroral cholangioscopy-guided electrohydraulic lithotripsy (POCS-EHL) is effective in these cases; however, it is expensive and time-consuming. Herein, we report a case of endoscopic lithotripsy for an impacted stone at the confluence of the cystic duct (CD) and CBD using a novel drill dilator.