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Review

Endoscopic Management of Difficult Biliary Stones: An Evergreen Issue

by
Magdalini Manti
1,
Jimil Shah
2,
Apostolis Papaefthymiou
3,4,
Antonio Facciorusso
5,
Daryl Ramai
6,
Georgios Tziatzios
1,
Vasilios Papadopoulos
4,
Konstantina Paraskeva
1,
Ioannis S. Papanikolaou
7,
Konstantinos Triantafyllou
7,
Marianna Arvanitakis
8,
Livia Archibugi
9,
Giuseppe Vanella
9,
Marcus Hollenbach
10 and
Paraskevas Gkolfakis
1,8,*
1
Department of Gastroenterology, “Konstantopoulio-Patision” General Hospital of Nea Ionia, 14233 Athens, Greece
2
Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
3
Endoscopy Unit, Cleveland Clinic London, London SW1X 7HY, UK
4
Department of Gastroenterology, General University Hospital of Larissa, 41110 Larissa, Greece
5
Gastroenterology Unit, Department of Medical Sciences, University of Foggia, 00161 Foggia, Italy
6
Gastroenterology and Hepatology, University of Utah Health, Salt Lake City, UT 84132, USA
7
Hepatogastroenterology Unit, Second Department of Internal Medicine—Propaedeutic, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, 12462 Athens, Greece
8
Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, University Hospital of Brussels (HUB), 1070 Brussels, Belgium
9
Pancreato-Biliary Endoscopy and Endosonography Division, Vita-Salute San Raffaele University, 20132 Milan, Italy
10
Medical Department II, Division of Gastroenterology, University of Leipzig Medical Center, D-04103 Leipzig, Germany
*
Author to whom correspondence should be addressed.
Medicina 2024, 60(2), 340; https://doi.org/10.3390/medicina60020340
Submission received: 23 December 2023 / Revised: 11 February 2024 / Accepted: 12 February 2024 / Published: 19 February 2024
(This article belongs to the Special Issue Latest Advances in Pancreatobiliary Endoscopy)
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Abstract

Choledocholithiasis is one of the most common indications for endoscopic retrograde cholangiopancreatography (ERCP) in daily practice. Although the majority of stones are small and can be easily removed in a single endoscopy session, approximately 10–15% of patients have complex biliary stones, requiring additional procedures for an optimum clinical outcome. A plethora of endoscopic methods is available for the removal of difficult biliary stones, including papillary large balloon dilation, mechanical lithotripsy, and electrohydraulic and laser lithotripsy. In-depth knowledge of these techniques and the emerging literature on them is required to yield the most optimal therapeutic effects. This narrative review aims to describe the definition of difficult bile duct stones based on certain characteristics and streamline their endoscopic retrieval using various modalities to achieve higher clearance rates.
Keywords: choledocholithiasis; ERCP; sphincteroplasty; mechanical lithotripsy; cholangioscopy choledocholithiasis; ERCP; sphincteroplasty; mechanical lithotripsy; cholangioscopy

Share and Cite

MDPI and ACS Style

Manti, M.; Shah, J.; Papaefthymiou, A.; Facciorusso, A.; Ramai, D.; Tziatzios, G.; Papadopoulos, V.; Paraskeva, K.; Papanikolaou, I.S.; Triantafyllou, K.; et al. Endoscopic Management of Difficult Biliary Stones: An Evergreen Issue. Medicina 2024, 60, 340. https://doi.org/10.3390/medicina60020340

AMA Style

Manti M, Shah J, Papaefthymiou A, Facciorusso A, Ramai D, Tziatzios G, Papadopoulos V, Paraskeva K, Papanikolaou IS, Triantafyllou K, et al. Endoscopic Management of Difficult Biliary Stones: An Evergreen Issue. Medicina. 2024; 60(2):340. https://doi.org/10.3390/medicina60020340

Chicago/Turabian Style

Manti, Magdalini, Jimil Shah, Apostolis Papaefthymiou, Antonio Facciorusso, Daryl Ramai, Georgios Tziatzios, Vasilios Papadopoulos, Konstantina Paraskeva, Ioannis S. Papanikolaou, Konstantinos Triantafyllou, and et al. 2024. "Endoscopic Management of Difficult Biliary Stones: An Evergreen Issue" Medicina 60, no. 2: 340. https://doi.org/10.3390/medicina60020340

APA Style

Manti, M., Shah, J., Papaefthymiou, A., Facciorusso, A., Ramai, D., Tziatzios, G., Papadopoulos, V., Paraskeva, K., Papanikolaou, I. S., Triantafyllou, K., Arvanitakis, M., Archibugi, L., Vanella, G., Hollenbach, M., & Gkolfakis, P. (2024). Endoscopic Management of Difficult Biliary Stones: An Evergreen Issue. Medicina, 60(2), 340. https://doi.org/10.3390/medicina60020340

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