Fig. 4. Endoscopic retrograde cholangiography images. (A) There is an oval-shaped filling defect in the distal common bile duct (CBD) (white arrowheads), with a size similar to that of the computed tomography-demonstrated soft tissue lesion. Upstream bile ducts are diffusely dilated, and there is a scanty amount of contrast medium passing into the duodenum (black arrowhead). An endoscopic drainage catheter was placed to decompress the bile ducts. (B) Sphincterotomy and subsequent endoscopic papillary balloon dilatation using a 12 mm balloon (white arrow) were performed. The floating filling defect is still visible in the CBD (white arrowheads). (C) After sphincterotomy, a basket (black arrow) was used to pull out the filling defect.
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