[Abstract only] Phillpotts S. et al., 2022: Endoscopic Management of Complex Biliary Stones.

Phillpotts S, Webster G, Arvanitakis M.
Department of Gastroenterology, University College London Hospitals, 250 Euston Road, London, England.
Department of Gastroenterology, University College London Hospitals, 250 Euston Road, London, England.
Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, CUB Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, Brussels 1070, Belgium.

Abstract

Complex biliary stones may be challenging to remove with standard endoscopic techniques. Factors contributing to complexity include large stone size (≥15 mm), multiple stones, high stone:distal duct ratio, stones above strictures and those in difficult anatomic position. In these cases, additional techniques may be needed, such as endoscopic papillary large balloon dilatation, mechanical lithotripsy, cholangioscopic visually directed lithotripsy, and extracorporeal shockwave lithotripsy. The choice of technique depends on local expertise and resources. Cases should be planned to identify the appropriate technique to avoid multiple procedures. This article describes the factors linked to difficulty and the steps to overcome them.
doi: 10.1016/j.giec.2022.02.002. Epub 2022 May 11. PMID: 35691692. Review.