Management of Difficult Choledocholithiasis

Alexander Podboy; Srinivas Gaddam; Kenneth Park; Kapil Gupta; Quin Liu; Simon K Lo

doi:10.1007/s10620-022-07424-9

Management of Difficult Choledocholithiasis

Dig Dis Sci. 2022 May;67(5):1613-1623. doi: 10.1007/s10620-022-07424-9. Epub 2022 Mar 29.

Authors

Alexander Podboy¹, Srinivas Gaddam¹, Kenneth Park¹, Kapil Gupta¹, Quin Liu¹, Simon K Lo²

Affiliations

¹ Pancreatic and Biliary Disease Program, Department of Digestive Diseases, Cedars Sinai Medical Center, 8700 Beverly Boulevard, South Tower, Suite 7511, Los Angeles, CA, 90048, USA.
² Pancreatic and Biliary Disease Program, Department of Digestive Diseases, Cedars Sinai Medical Center, 8700 Beverly Boulevard, South Tower, Suite 7511, Los Angeles, CA, 90048, USA. Simon.Lo@cshs.org.

PMID: 35348969
DOI: 10.1007/s10620-022-07424-9

Abstract

Over 30% of all endoscopic retrograde cholangiography procedures in the US are associated with biliary stone extraction, and over 10-15% of these cases are noted to be complex or difficult. The aim of this review is to define the characteristics of difficult common bile duct stones and provide an algorithmic therapeutic approach to these difficult cases. We describe additional special clinical circumstances in which difficult biliary stones are identified and provide additional management strategies to aid endoscopic stone extraction efforts.

Keywords: Endoscopic retrograde cholangioscopy (ERC); Gallstones; Lithotripsy.

Publication types

Review

MeSH terms

Catheterization / methods
Cholangiopancreatography, Endoscopic Retrograde / methods
Choledocholithiasis* / diagnostic imaging
Choledocholithiasis* / surgery
Gallstones* / therapy
Humans
Lithotripsy* / methods
Treatment Outcome