Management of difficult common bile duct stones

Hochberger, J.; Tex, S.; Maiß, J.; Hahn, Eckhart G.

doi:10.1016/s1052-5157(03)00102-8

Cited by 102 publications

(90 citation statements)

References 23 publications

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“…Endoscopic laser lithotripsy is the most recent method, but its use is still limited, also owing to the need for costly equipment (9). Recent laser lithotriptors combine the advantages of dye and solid-state lasers at a reasonably low price (10), thus potentially allowing for a future progressive diffusion of laser lithotripsy worldwide (10,11). The critical determining factors for the success of extracorporeal shock-wave lithotripsy (ESWL) are stone size/structure (12) and CBD diameter (13).…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of incarcerated calculi via laparoscopic bile duct exploration using laparotomy biliary lithotomy forceps

Jiang¹,

Wang²,

Jin³

et al. 2016

Experimental and Therapeutic Medicine

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Abstract. The present study aimed to investigate the practicability and clinical value of applying laparotomy biliary lithotomy forceps to laparoscopic bile duct exploration (LCBDE) for the surgical treatment of incarcerated calculi. A total of 63 patients were diagnosed with cholecystolithiasis and choledocholithiasis. The present study performed a retrospective analysis of clinical samples from 16 of these patients who had incarcerated calculi at the terminus of the common bile duct, and who had been treated with laparoscopic cholecystectomy and LCBDE. During the procedure, laparotomy biliary lithotomy forceps were used to gently remove the calculi from the common bile duct. Of the surgical procedures that used laparotomy biliary lithotomy forceps, one case was unsuccessful and 15 cases were successful. The results of the present study suggested that it may be clinically advisable to use laparotomy biliary lithotomy forceps to remove incarcerated calculi from the common bile duct during a laparoscopy, since it is easy, economical and effective.

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Section: Discussionmentioning

confidence: 99%

Surgical treatment of incarcerated calculi via laparoscopic bile duct exploration using laparotomy biliary lithotomy forceps

Jiang¹,

Wang²,

Jin³

et al. 2016

Experimental and Therapeutic Medicine

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“…However, in the presence of large or numerous stones, or when the papilla does not allow extensive ES, the usual technique is proved to be unable to extract the stones in up to 15% of the cases [3,4,10]. Under these circumstances, we may use mechanical lithotripsy (involving shock waves, laser or electrohydraulics) or to opt for surgery [10].…”

Section: Discussionmentioning

confidence: 99%

“…In the past, mechanical lithotripsy was more often used, and if this technique failed, surgery was decided. In elderly patients or individuals with a high surgical risk, the placement of plastic biliary stents is an acceptable alternative [4]. However, the devices used for mechanical lithotripsy are often complicated to assemble and handle.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of sphincterotomy with sphincteroplasty using large caliber balloons in the treatment of choledocholithiasis with extraction difficulties

Uribarrena-Amezaga¹,

Serna²,

Calvo-Morillas³

et al. 2013

OJGas

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Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (ES) is the most widely used technique for treating choledocholithiasis.In some cases, due to anomalies of the papilla or the presence of large or multiple calculi, additional maneuvers are needed to remove the stones. The present study investigates the efficacy and safety of ES with sphincteroplasty (SP) in the management of choledocholithiasis with extraction difficulties. Patients and Methods: A prospective study was made of 153 patients with choledocholithiasis subjected to ERCP. Fifty-two patients underwent ES with SP, while 101 were subjected only to ES. The two groups were compared in terms of age, gender, percentage cannulation, presence of papilla alterations, large or multiple stones, success in stone removal and complications (acute pancreatitis, bleeding and perforation). In the ES with SP group, we moreover recorded the diameters of the balloons employed (10 -18 mm). Results: There were no significant differences between the groups in the stone extraction success rate (94.23% in the ES with SP group versus 97.03% in the ES group) or in the appearance of complications (3.8% in the ES with SP group versus 2.7% in the ES group). The presence of difficult papillae, and of multiple or large stones was significantly greater in the ES with SP group. The diameter of the balloon was not associated with the appearance of complications. Conclusion: Endoscopic sphincterotomy with sphincteroplasty is effective and safe in the treatment of choledocholithiasis with extraction difficulties.

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“…More than 80% of all common bile duct stones can be effectively treated by endoscopic sphincterotomy and stone extraction using baskets or balloon catheters. For stones up to 2.5 centimeters in diameter, mechanical lithotripsy is the method of choice for the next step [4]. Matsumoto et al [5] reported a successful removal of large common bile duct stones using an endoscopic maneuver; however, the larger size [6] and impact [7] of common bile duct stones were an important factor for failure of endoscopic management.…”

Section: Discussionmentioning

confidence: 99%

Giant common bile duct stone

2011

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AbstractBile duct stones, which obstruct the common bile duct, potentially result in complications, such as acute cholangitis and pancreatitis. We present a case involving a patient with normal liver function tests from whom we removed a giant common bile duct stone measuring 7.5 centimeters × 4.0 centimeters × 4.0 centimeters. Postoperatively recurrent common bile duct stones were observed and removed with an endoscopic maneuver in the three-year follow-up period. Recurrent bile duct stones are frequently reported in the case of large size of stones or multiple stones. Surgical treatment may then be considered as a first-line treatment in cases of recurrent common bile duct stones. When an endoscopic or surgical approach is used for the treatment of giant common bile duct stones, careful observation is of the utmost importance and treatment innovations may be necessary.

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Management of difficult common bile duct stones

Cited by 102 publications

References 23 publications

Surgical treatment of incarcerated calculi via laparoscopic bile duct exploration using laparotomy biliary lithotomy forceps

Surgical treatment of incarcerated calculi via laparoscopic bile duct exploration using laparotomy biliary lithotomy forceps

Efficacy and safety of sphincterotomy with sphincteroplasty using large caliber balloons in the treatment of choledocholithiasis with extraction difficulties

Giant common bile duct stone

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