Endoscopic transpapillary gallbladder drainage (ETGBD) is one of the most difficult endoscopic retrograde cholangiopancreatography (ERCP)-related procedures to perform, as it often causes adverse events in the gallbladder duct ¹ . Retrieval is technically difficult if a sheared guidewire remnant remains in the gallbladder duct. Herein, we present a case in which a sheared guidewire remnant was successfully retrieved from the gallbladder duct using a novel basket catheter.

A 78-year-old man was admitted to our hospital with acute cholecystitis ( Fig. 1 ). He was promptly treated using antibiotics and ETGBD. While manipulating the guidewire in the gallbladder duct, the guidewire became kinked, broke off, and remained in the duct ( Fig. 2 a, b ). We attempted to retrieve the sheared guidewire using a RASEN 2 basket catheter (Kaneka Medical, Osaka, Japan) that was inserted along the guidewire, deployed into the gallbladder duct, and rotated clockwise to confirm that the guidewire remnant was inside ( Fig. 2 c ). Once we closed the basket, we were able to firmly grip the guidewire and pull it out of the patient through the channel of the endoscope ( Fig. 2 d , Fig. 3 ).

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Fig. 1

Computed tomography image showing acute cholecystitis on the patient’s day of admission.

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Fig. 2

Fluoroscopic images of endoscopic transpapillary gallbladder drainage procedure. a Guidewire manipulation in the gallbladder duct. b Sheared guidewire remnant in the gallbladder duct. c A basket catheter was inserted into the gallbladder duct along the guidewire. d Successful grasping and retrieval of the sheared guidewire remnant.

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Fig. 3

The sheared guidewire remnant and basket catheter.

There have been few reports in the literature concerning techniques for retrieving residual guidewires, mostly using biopsy forceps during endoscopic ultrasound or ERCP ^{2 3} . To our knowledge, no studies have yet described remnant guidewire retrieval in the gallbladder duct using a basket catheter. This new type of basket catheter has a unique shape and rotational mechanism that may be useful not only for removing bile duct stones but also for retrieving foreign bodies in narrow areas such as the gallbladder duct ( ^{Video 1} ).

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