Advances in the endoscopic management of common bile duct stones

Guru V Trikudanathan, Mustafa A Arain, Rajeev Attam, Martin L Freeman

Research output: Contribution to journalReview articlepeer-review

37 Scopus citations


Extraction of common bile duct stones by endoscopic retrograde cholangiopancreatography generally involves biliary sphincterotomy, endoscopic papillary balloon dilation or a combination of both. Endoscopic papillary large-balloon dilation after sphincterotomy has increased the safety of large stone extraction. Cholangioscopically directed electrohydraulic and laser lithotripsy using single-operator mother-daughter systems or direct peroral cholangioscopy using ultraslim endoscopes are increasingly utilized for the management of refractory stones. In this Review, we focus on advances in endoscopic approaches and techniques, with a special emphasis on management strategies for 'difficult' common bile duct stones.

Original languageEnglish (US)
Pages (from-to)535-544
Number of pages10
JournalNature Reviews Gastroenterology and Hepatology
Issue number9
StatePublished - Sep 2014


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