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. 2021 Aug 10;38(3):340–347. doi: 10.1055/s-0041-1731372

Fig. 1.

Fig. 1

Choledochoscopy in a 68-year-old female with remote history of Roux-en-Y gastric bypass presents with abdominal pain and elevated bilirubin. ( a ) Coronal MIP T2-weighted MRI demonstrates a large stone within the proximal common bile duct with associated internal and external biliary dilatation. ( b ) Cholangiography after placement of an internal/external biliary drain again demonstrates the choledocolith, as well as moderate biliary dilatation. ( c ) Spot radiograph taken during choledocoscopy demonstrates our SpyGlass endoscope directed toward the common bile duct calculus. We placed a safety wire into the bowel during the choledocoscopy to retain access during lithotripsy and stone extraction. ( d ) Cholangiography 2 weeks post choledocoscopy demonstrates a patent common bile duct with resolution of choledocolithasis.

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