PDF(Pubmed)
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.
摘要：
胆总管结石是内镜逆行胰胆管造影术（ERCP）在日常实践中最常见的适应症之一。尽管大多数结石都很小，并且可以在一次内窥镜检查中轻松清除，大约10-15%的患者有复杂的胆道结石，需要额外的程序来获得最佳的临床结果。大量的内镜方法可用于清除困难的胆道结石，包括乳头状大球囊扩张，机械碎石术,以及电动液压和激光碎石术。需要对这些技术和关于它们的新兴文献的深入了解才能产生最佳的治疗效果。这篇叙述性综述旨在根据某些特征描述困难胆管结石的定义，并使用各种方式简化内镜下取石术，以实现更高的清除率。
