A 48-year-old man had a fully covered metal stent embedded in the bile-duct wall after liver surgery, preventing conventional removal. Cholangioscopy-guided Ho:YAG laser ablation exposed and fragmented the stent, enabling complete retrieval over three sessions without reported procedure-related adverse events. It is a promising salvage technique supported by only one case.
Key findings
- Complete stent removal and biliary recanalisation were achieved over three sessions, with no procedure-related adverse events reported. Direct visualisation allowed the ablation and fragmentation to be directed at the target tissue and mesh.
Why this matters globally
The technique may offer an additional option before surgery or prolonged repeated drainage in rare cases of deeply embedded stents, but it requires specialised equipment, advanced expertise and robust complication management.
Thai researcher contribution
Senior author Hiroyuki Isayama is affiliated with Juntendo University and the Division of Gastroenterology, Faculty of Medicine, Chulalongkorn University. OpenAlex incorrectly mapped the Thai affiliation to Toray (Thailand); the record has been corrected using publisher and public affiliation evidence. The clinical case was managed by the Japanese team and is not a Thai-patient dataset.
Limitations to consider
A single case without a comparator cannot establish success rates, bleeding, perforation, thermal injury, cost or long-term outcomes elsewhere; three sessions were required. Absence of an adverse event in one patient does not establish safety.
Verify the original sources
EndoscopyRead the original article↗DOI: 10.1055/a-2893-7127