Supplementary material 1
This video shows how to perform modified double-guidewire technique using an uneven double lumen cannula (uneven method) in patients with surgically altered gastrointestinal anatomy depending on the two situations (“axis matched” and “lumen-replaced”) in detail.
The DBE scope was exchanged for an ultraslim endoscope, leaving the overtube with its balloon inflated. The ultraslim endoscope was advanced through the overtube up to the hepaticojejunostomy anastomosis and directly inserted into the intrahepatic bile duct. Residual stones were detected and extracted using a 5-Fr basket catheter and suction after normal saline irrigation. Residual stones were completely removed.