No X-ray monitoring to ensure the safety of pregnant women and fetuses Recently, a 35-year-old pregnant woman in her fifth month of pregnancy was admitted to the Department of Gastroenterology with right-sided back pain, and developed fever and chills that night. This is a serious complication of biliary tract disease, and if not treated urgently, severe infection and shock will soon occur, endangering the patient’s life. The conventional treatment is to perform endoscopic retrograde cholangiopancreatography (ERCP) to remove the stone and relieve the biliary obstruction. ERCP has to be performed under X-ray surveillance, and the exposure time to X-ray is long. For pregnant women, it may cause embryonic abnormalities that may lead to mental retardation of the child, or even miscarriage or stillbirth. After a group consultation, the surgeons concluded that the wound might not close after the operation due to high abdominal pressure, and that the patient had undergone gallbladder surgery, which would make the operation more difficult if there were adhesions, and the risks to the pregnant woman and the fetus were self-evident. When the patient’s family understood the whole condition, they were very anxious, fearing that something might happen to the pregnant woman and the fetus, and the pregnant woman was of advanced age, so if she gave up this chance to have a baby, there might be some unknowable factors for another pregnancy. Under the coordination of Director Fan Jiangao of the Department of Gastroenterology, Dr. Wang Xuefeng, Deputy Chief Physician of the Department of Surgery, Dr. Wang Yuqin and Dr. Wang Baocan of the Department of Gastroenterology discussed urgently and boldly formulated a treatment plan to implant a common bile duct stent for the elderly pregnant woman without X-ray surveillance to solve the biliary obstruction and ensure the safety of the pregnant woman and the fetus. The implantation of a common bile duct stent under non-X-ray surveillance is equivalent to driving at night without driving lights, requiring the surgeon to be highly skilled and complete the surgery in a short time. With the collaboration of two medical and surgical surgeons, Xuefeng Wang and Yuqin Wang, the whole operation was successfully inserted quickly and accurately, and completed within 10 minutes. On the second day after the operation, the patient’s symptoms were significantly reduced, her body temperature returned to normal, the jaundice index dropped significantly, and the mother and child were safe and sound. Two days later, the pregnant woman was discharged from the hospital. Endoscopic retrograde cholangiopancreatography (ERCP) is a minimally invasive technique for diagnosis and treatment of biliary and pancreatic diseases, which is characterized by less trauma, faster patient recovery, fewer complications, less risk and relatively lower cost, and has replaced surgical treatment in many aspects. In the past two years, Xinhua Hospital has successfully completed a large number of emergency critical care and difficult ERCP operations, which are well received by patients.