Endoscopic Management of Difficult Biliary Stones: An Evergreen Issue

Choledocholithiasis is one of the most common indications for endoscopic retrograde cholangiopancreatography (ERCP) in daily practice. Although the majority of stones are small and can be easily removed in a single endoscopy session, approximately 10–15% of patients have complex biliary stones, requ...

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Bibliographic Details
Main Authors: Magdalini Manti, Jimil Shah, Apostolis Papaefthymiou, Antonio Facciorusso, Daryl Ramai, Georgios Tziatzios, Vasilios Papadopoulos, Konstantina Paraskeva, Ioannis S. Papanikolaou, Konstantinos Triantafyllou, Marianna Arvanitakis, Livia Archibugi, Giuseppe Vanella, Marcus Hollenbach, Paraskevas Gkolfakis
Format: Article
Language:English
Published: MDPI AG 2024-02-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/60/2/340
Description
Summary:Choledocholithiasis is one of the most common indications for endoscopic retrograde cholangiopancreatography (ERCP) in daily practice. Although the majority of stones are small and can be easily removed in a single endoscopy session, approximately 10–15% of patients have complex biliary stones, requiring additional procedures for an optimum clinical outcome. A plethora of endoscopic methods is available for the removal of difficult biliary stones, including papillary large balloon dilation, mechanical lithotripsy, and electrohydraulic and laser lithotripsy. In-depth knowledge of these techniques and the emerging literature on them is required to yield the most optimal therapeutic effects. This narrative review aims to describe the definition of difficult bile duct stones based on certain characteristics and streamline their endoscopic retrieval using various modalities to achieve higher clearance rates.
ISSN:1010-660X
1648-9144