With our pleasure, we present you a clinical observation of recurrent halidohalidiasis caused by a surgical thread of the common bile duct detected and removed by a video halangioscopy. A 68-year-old female patient was admitted to our hospital with a clinical picture of obstructive jaundice. Addictional examination revealed a three-fold increase in the total bilirubin level and a two-fold increase in liver enzymes. During transectomal ultrasound, attention was drawn to the dilation of the common bile duct with stones of various sizes. From the analysis, it was known that in 2007, the patient underwent halitostectomy and Y-shaped drainage of the CBD for urgent indication. In subsequent years, the patient underwent six ERCPs for recurrent halidohalidiasis. The diagnooscopy was performed, and the sphincterotomy area was located at the edge of a large tie verticulum. The halangiogram shown a large number of irregularly shaped stones ranging in size from 5 to 15 mm. After performing balloon dilation of the FSD area and litho-extraction, it was decided to conduct a direct endoscopic examination of the bile ducts, taking into account the patient's history. Perioral digital halangioscopy using spyglass revealed a tight-fitting ligature with a fixed stone of at least 10 mm in size in the CBD wall above the confluence of the cystic duct. The fragmentation of the stone was performed using holmium-less lithotripta. Then, using spy-bite biopsy forceps, it was possible to particularly extract the ligature from the thickness of the CBD wall, but it wasn't possible to completely remove it. After changing the duodenoscope to an ultrathin gastroscope, we managed to directly enter the common bile duct and grab the ligature with a polypectomy snare at a distance of about 1 mm from the duct wall. In the mode of cutting and coagulation, creating additional traction, the ligature was extracted from the CBD wall. On the control halangioscopy, a small cradle-like depression was noted in the area where the ligature was previously determined, without sign of perforation or bleeding. The postoperative period was unventful. The patient was discharged three days after the operation. After more than a year of observation, clinical, laboratory and ultrasound data for a relapse of this disease were not obtained. When treating recurrent halitic halitiasis, it's necessary to pay careful attention to the details of previously performed operation on the organs of pancreatobiliary zone. The cause of recurring stones, as demonstrated in our case, can be foreign body of the CBD, in particular a surgical threat. It's almost impossible to diagnose its presence only on the basis of X-ray examination. It is direct halangioscopy that makes it possible to detect and remove the threat, thereby interrupting the patient's suffering and the chain of multiple endoscopic interventions.

clinical observation

68-year-old female patient

recurrent halidohalidiasis

surgical thread

common bile duct