ERCP Management of Complicated Stone Disease of the Bile Duct and Pancreas

Nithin Karanth, Ashley A. Vareedayah, Jonathan Cohen, Gregory B. Haber

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

Abstract

While the majority of the stones can be removed via basic standard techniques of endoscopic retrograde cholangiopancreatography, there are occasional situations which require a more advanced approach. This chapter reviews management of complex stone disease of the pancreaticobiliary tract that poses a challenge to the endoscopist, the tools available to deal with these problems, and the ideal ways in which competence in these techniques can be achieved and maintained. When standard techniques fail to clear stones from the biliary and/or pancreatic duct, mechanical lithotripsy can increase the success rate to greater than 90–95%. An alternative method to mechanical lithotripsy in the removal of large stones has been the use of large-diameter dilation balloons, 12–18mm in diameter, across the biliary sphincter with subsequent removal of large stones in one piece. Cholangiopancreatoscopy has been frequently used to assist in the removal of difficult pancreatic and bile duct stones.

Original languageEnglish
Title of host publicationSuccessful Training in Gastrointestinal Endoscopy, Second Edition
Publisherwiley
Pages345-353
Number of pages9
ISBN (Electronic)9781119529675
ISBN (Print)9781119529644
DOIs
StatePublished - 1 Jan 2021
Externally publishedYes

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