Fig. 1. (A) A 15-mm stone was identified within a large remnant gallbladder. (B) Puncture of the remnant gallbladder with a 10×15 mm Hot AXIOS stent through the duodenal bulb under fluoroscopic control. (C) Access through the cholecysto-duodenostomy. Lithotripsy and extraction of the stone with a basket was performed. (D, E) Same-session stent extraction was performed based on the high probability of postsurgical fibrosis between the gallbladder and the duodenal wall. (F) Full-thickness mucosal closure with mantis-like claw clips.