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How Best to Manage Large Biliary Stones?

How Best to Manage Large Biliary Stones?

21 Aug 2021 14:07 14:14
(7 mins)
Lee Dong-Ki Speaker
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Endoscopic treatment is recognized as the first-line treatment for bile duct stones. Endoscopic sphincterotomy (EST) combined with basket and or balloon catheter is generally carried out for stone extraction. Large bile duct stones are typically treated by mechanical lithotripsy (MLT). However, currently endoscopic papillary large balloon dilation (EPLBD) has substituted MLT. The presence of distal common bile duct stricture is a contraindication for this procedure due to the high risk of perforation.
When the MLT and EPLBD are not successful, alternative methods, including laser lithotripsy, should be employed. Therefore, most bile duct stones can be treated successfully with endoscopic technic. But all ERCP doctors should keep in mind that patient safety is the prime priority. Therefore, the operators should think about safe alternative measures when they face unexpected difficulties.

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