Endoscopic management of the difficult common bile duct stone.
Over the past two decades, endoscopic sphincterotomy has become the primary therapy for retained or recurrent choledocholithiasis. Nevertheless, in about 10% of patients, complete ductal clearance is not possible using standard balloon and basket techniques. A variety of endoscopically guided lithotripsy devices can substantially improve the chances of extracting stones that are resistant to conventional methods. Fiberoptic technology has advanced to the point where these procedures can be performed under direct vision through ultrathin fiberscopes. This paper examines the current experience with these intracorporeal techniques for the difficult common bile duct stone.
Graham
S M
SM
Department of Surgery, University of Maryland Medical Center, Baltimore 21201.
Flowers
J L
JL
Zucker
K A
KA
D016145:Endoscopy, Digestive System; D042882:Gallstones / Q000628:therapy*; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D017602:Lithotripsy, Laser / Q000379:methods