Cracking Difficult Biliary Stones

Abstract

Since the introduction of endoscopic biliary sphincterotomy in 1974, 1,2 the management of bile duct stones has shifted from surgical bile duct exploration to an endoscopic approach. However, there is a 15% failure rate of bile duct stone removal with standard biliary sphincterotomy plus stone extraction with either a balloon, a basket catheter, or their combination. 3 Stone factors (e.g., size, number, or shape), bile duct factors (e.g., associated stricture, narrowing, or angulation), and the relationship between the stone and the bile duct (e.g., impact

Consenso de indicadores de calidad en la atención en colangiopancreatografía retrógrada endoscópica

“…Las técnicas convencionales utilizadas en la resolución de coledocolitiasis tienen una tasa de fracaso del 10 al 15% de los casos [65][66][67] . La colocación de una prótesis biliar plástica temporal es una alternativa útil y segura cuando las técnicas de extracción avanzada han fallado o no están disponibles de manera inmediata y se considera un estándar de calidad durante el procedimiento.…”

Outcomes of balloon vs basket catheter for clearance of choledocholithiasis: a systematic review and meta-analysis

“…Outcomes of balloon vs basket catheter for clearance of choledocholithiasis: a systematic review and meta-analysis This is usually sufficient for CBD stones ≤ 10 mm in diameter. Larger stones may require advanced methods such as mechanical lithotripsy (ML), laser lithotripsy, or cholangioscopic lithotripsy [2,8]. Both the American Society for Gastrointestinal Endoscopy (ASGE) and the European Society of Gastrointestinal endoscopy (ESGE) have published guidelines for management of CBD stones, but there is no evidence to support the use of either device over the other [2,7].…”

The classic never dies. Efficacy of the classical method in biliary lithotripsy: fragmentation of biliary lithiasis by direct peroral cholangioscopy with electrohydraulic probe for the treatment of biliary lithiasis

“…Nowadays, biliary lithotripsy is usually performed using mother-baby scope systems with Spyglass, although it is still possible to use an electrohydraulic probe by direct cholangioscopy in centers where this technique is not available 1 2 3 .…”