Stubborn stones: breakages of a mechanical lithotripter by an exceptionally hard gallstone.

Endoscopic retrograde cholangiopancreatography (ERCP) is the predominate method of removing common bile duct (CBD) calculi.1 The simplest and quickest way of removing large CBD calculi during ERCP is a mechanical lithotripter to crush the gallstone before removing the crushed fragments using balloon sweeping or a dormia extraction basket. We describe a case where the handle of the mechanical lithotripter broke off the metal sheath during crushing of an exceptionally hard 2 cm gallstone in an 83-year-old patient. This left the wire basket …