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Namyoung Park, Woo Hyun Paik
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Fig. 1
(A) Computed tomography scan shows diffuse pneumobilia with distal CBD stone (white arrow). (B) ERCP findings. The major papilla was naïve, and after endoscopic sphincterotomy, brown muddy stones and sludge were removed with stone retrieval balloon catheter. CBD, common bile duct; ERCP, endoscopic retrograde cholangiopancreatography.
Fig. 2
Second ERCP findings. Multiple biliary strictures developed at the hilum and common hepatic duct, and endobiliary biopsy was done at the stricture site. Since gallbladder stone was noted, endoscopic gallbladder drainage was performed to prevent recurrent cholangitis. ERCP, endoscopic retrograde cholangiopancreatography.
Fig. 3
(A) Third ERCP findings. Barrel-shaped biliary cast was removed with basket catheter. Since multifocal biliary strictures were aggravated at the intrahepatics, a biliary stent was inserted into the right intrahepatic duct. (B) Magnetic resonance imaging shows diffuse wall thickening of the bile duct (sky blue arrows). ERCP, endoscopic retrograde cholangiopancreatography.
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