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Management of Difficult Bile Duct Stones by Large Balloon, Cholangioscopy, Enteroscopy and Endosonography

Hirofumi Kogure|Tsuyoshi Hamada|Hiroyuki Isayama|Kazuhiko Koike|Naminatsu Takahara|Tomotaka Saito|Suguru Mizuno|Minoru Tada|Tatsuya Sato|Yousuke Nakai|Ryunosuke Hakuta|Kazunaga Ishigaki|Kei Saito
거트앤리버 소화기연관학회협의회|2020.05|Gut and Liver|제14권 제3호|pp. 297-305|DOI 10.5009/gnl19157

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참고문헌

키워드

Cholangiopancreatographyendoscopic retrogradeEndosonographyLithotripsyCholangioscopeCholeodcholithiasis

초록

Endoscopic management of bile duct stones is now the standard of care, but challenges remain with difficult bile duct stones. There are some known factors associated with technically difficult bile duct stones, such as large size and surgically altered anatomy. Endoscopic mechanical lithotripsy is now the standard technique used to remove large bile duct stones, but the efficacy of endoscopic papillary large balloon dilatation (EPLBD) and cholangioscopy with intraductal lithotripsy has been increasingly reported. In patients with surgically altered anatomy, biliary access before stone removal can be technically difficult. Endotherapy using two new endoscopes is now utilized in clinical practice: enteroscopy-assisted endoscopic retrograde cholangiopancreatography and endoscopic ultrasound-guided antegrade treatment. These new approaches can be combined with EPLBD and/or cholangioscopy to remove large bile duct stones from patients with surgically altered anatomy. Since various endoscopic procedures are now available, endoscopists should learn the indications, advantages and disadvantages of each technique for better management of bile duct stones.

Abstract

Endoscopic management of bile duct stones is now the standard of care, but challenges remain with difficult bile duct stones. There are some known factors associated with technically difficult bile duct stones, such as large size and surgically altered anatomy. Endoscopic mechanical lithotripsy is now the standard technique used to remove large bile duct stones, but the efficacy of endoscopic papillary large balloon dilatation (EPLBD) and cholangioscopy with intraductal lithotripsy has been increasingly reported. In patients with surgically altered anatomy, biliary access before stone removal can be technically difficult. Endotherapy using two new endoscopes is now utilized in clinical practice: enteroscopy-assisted endoscopic retrograde cholangiopancreatography and endoscopic ultrasound-guided antegrade treatment. These new approaches can be combined with EPLBD and/or cholangioscopy to remove large bile duct stones from patients with surgically altered anatomy. Since various endoscopic procedures are now available, endoscopists should learn the indications, advantages and disadvantages of each technique for better management of bile duct stones.

참고문헌 (52)

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관련 논문AI추천

Recent advances in the management of difficult bile-duct stones: a focus on single-operator cholangioscopy-guided lithotripsy동석호, 오치혁대한내과학회 · The Korean Journal of Internal Medicine2021 · 제36권 제2호Feasibility of Endoscopic Papillary Large Balloon Dilation in Patients with Difficult Bile Duct Stones without Dilatation of the Lower Part of the Extrahepatic Bile DuctAkito Iwasaki, Atsushi Nakajima, Kensuke Kubota, Kentaro Sakamaki, Kunihiro Hosono, Nobuyuki Matsuhashi, Takamitsu Sato, Toshio Fujisawa, Yuji Fujita, Yusuke Sekino거트앤리버 소화기연관학회협의회 · Gut and Liver2017 · 제11권 제1호Cracking Difficult Biliary StonesPhonthep Angsuwatcharakon, Rungsun Rerknimitr대한소화기내시경학회 · Clinical Endoscopy2021 · 제54권 제5호How Should Biliary Stones be Managed?심찬섭거트앤리버 소화기연관학회협의회 · Gut and Liver2010 · 제4권 제2호Utility of Direct Peroral Cholangioscopy Using a Multibending Ultraslim Endoscope for Difficult Common Bile Duct Stones이윤나, 조영덕, 차상우, Lee Tae Hoon, Lee Won Myung, Moon Jong Ho, Park Sang-Heum, Shin Il Sang, Yang Jae Kook거트앤리버 소화기연관학회협의회 · Gut and Liver2022 · 제16권 제4호Evolving Strategies for the Optimal Management of Common Bile Duct StonesChon Hyung Ku, Jo Ik Hyun, Park Chang Hwan거트앤리버 소화기연관학회협의회 · Gut and Liver2025 · 제19권 제5호

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