Alternative methods in the endoscopic management of difficult common bile duct stones

Dong Ki Lee, Jae Hoon Jahng

Research output: Contribution to journalReview articlepeer-review

19 Citations (Scopus)


The endoscopic method is accepted as a first treatment modality in the management of extrahepatic bile duct. Most large stones can be removed with basket and mechanical lithotripsy after endoscopic sphincterotomy. Currently, in treating large extrahepatic bile duct stones, endoscopic papillary large balloon dilation with mid-incision endoscopic sphincterotomy is actively performed instead of applying mechanical lithotripsy after full endoscopic sphincterotomy. Herein, we describe the conceptions, proper indications, methods and complications of endoscopic papillary large balloon dilation with regards to currently published reports. In addition, intracorporeal lithotripsy by peroral cholangioscopy with an ultra-slim upper endoscope is introduced, which is more convenient than previous conventional intracorporeal lithotripsy methods using mother-baby endoscopy or percutaneous transhepatic cholangioscopy. Lastly, biliary stenting with the choleretic agent administration method is briefly reviewed as an alternative treatment option for frail and elderly patients with large impacted common bile duct stones.

Original languageEnglish
Pages (from-to)S79-S84
JournalDigestive Endoscopy
Issue numberSUPPL. 1
Publication statusPublished - 2010 Jul

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology


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