EUS-guided intrahepatic bile duct stone extraction via choledochoduodenostomy created by a lumen-apposing metal stent

Intrahepatic bile duct (IHBD) stones often occur in patients with surgical bilioenteric anastomosis. An endoscopic approach through the anastomosis is attempted first. If that is not possible, a percutaneous transhepatic approach is considered. Interventional EUS therapy for IHBD stones was recently reported as an alternative method. Herein we describe a novel extraction method for IHBD stones through a lumen-apposing biflanged metal stent...