title: Current situation of endoscopic treatment for common bile duct stones.
abstract: OBJECTIVE
  The progression of endoscopy and devices as well as newly developed treatment methods have enabled endoscopic lithotomy. In this study, we examined to what degree is it possible to endoscopically treat patients who are diagnosed as having common bile duct stones.
  
  
  METHODS
  Lithotomy was conducted using a backward side-viewing endoscope for patients without surgical history of upper gastrointestinal tract and patients with stomach reconstructed with Billroth-I method, using an ordinary endoscope for patients with stomach reconstructed with Billroth-II method (Bil-II) and using a double balloon endoscope for patients with difficulty in reaching the papilla or patients of Roux-en-Y anastomosis (R-Y). As for treatment methods, we selected endoscopic sphincterotomy as the first choice for papilla treatment and selected endoscopic papillary balloon dilation for patients with bleeding tendency or patients of Bil-II or R-Y. For patients with multiple stones or giant stones, lithotripsy was selected depending on judgment of the endoscopist.
  
  
  RESULTS
  Endoscopic complete lithotomy was successful in 97.7% (168/172). An accidental disease was observed in 2.9% (5/172). In one patient with the perforated gastrointestinal tract, a surgery was performed but others were mild.
  
  
  CONCLUSIONS
  Common bile duct stones can be endoscopically treated safely with high rate.
authors.affiliation: Department of Medicine and Clinical Oncolgy, Graduate School of Medicine, Chiba University, Chiba, Japan. sakai4754@yahoo.co.jp
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sakai
authors.forename: Toshio
authors.initials: T
authors.lastname: Tsuyuguchi
authors.forename: Harutoshi
authors.initials: H
authors.lastname: Sugiyama
authors.forename: Takao
authors.initials: T
authors.lastname: Nishikawa
authors.forename: Katsunobu
authors.initials: K
authors.lastname: Tawada
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Saito
authors.forename: Jo
authors.initials: J
authors.lastname: Kurosawa
authors.forename: Rintaro
authors.initials: R
authors.lastname: Mikata
authors.forename: Motohisa
authors.initials: M
authors.lastname: Tada
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ishihara
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokosuka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004106:Dilatation; D058582:Double-Balloon Enteroscopy / Q000009:adverse effects; D005260:Female; D042882:Gallstones / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007564:Japan; D008096:Lithotripsy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects; D016896:Treatment Outcome