Endoscopic management of difficult common bile duct stones  

作　　者：Guru Trikudanathan Udayakumar Navaneethan Mansour A Parsi 

机构地区：[1]Department of Internal Medicine,University of Connecticut Medical Center,Farmington,CT 06269,United States [2]Digestive Disease Institute,Cleveland Clinic,Cleveland,OH 44195,United States

出　　处：《World Journal of Gastroenterology》2013年第2期165-173,共9页世界胃肠病学杂志（英文版）

摘　　要：Endoscopy is widely accepted as the first treatment option in the management of bile duct stones.In this review we focus on the alternative endoscopic modalities for the management of difficult common bile duct stones.Most biliary stones can be removed with an extraction balloon,extraction basket or mechanical lithotripsy after endoscopic sphincterotomy.Endoscopic papillary balloon dilation with or without endoscopic sphincterotomy or mechanical lithotripsy has been shown to be effective for management of difficult to remove bile duct stones in selected patients.Ductal clearance can be safely achieved with peroral cholangioscopy guided laser or electrohydraulic lithotripsy in most cases where other endoscopic treatment modalities have failed.Biliary stenting may be an alternative treatment option for frail and elderly patients or those with serious co morbidities.Endoscopy is widely accepted as the first treatment option in the management of bile duct stones. In this review we focus on the alternative endoscopic modalities for the management of difficult common bile duct stones. Most biliary stones can be removed with an extraction balloon, extraction basket or mechanical lithotripsy after endoscopic sphincterotomy. Endoscopic papillary balloon dilation with or without endoscopic sphincterotomy or mechanical lithotripsy has been shown to be effective for management of difficult to remove bile duct stones in selected patients. Ductal clearance can be safely achieved with peroral cholangioscopy guided laser or electrohydraulic lithotripsy in most cases where other endoscopic treatment modalities have failed. Biliary stenting may be an alternative treatment option for frail and elderly patients or those with serious co morbidities.

关 键 词：CHOLEDOCHOLITHIASIS Mechanical LITHOTRIPSY Laser LITHOTRIPSY Electrohydra-ulic LITHOTRIPSY DIFFICULT to remove biliary STONES Endoscopic large balloon PAPILLARY dilation Peroral CHOLANGIOSCOPY 

分 类 号：R657.4[医药卫生—外科学]