Opinion Review
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 28, 2021; 27(44): 7597-7611
Published online Nov 28, 2021. doi: 10.3748/wjg.v27.i44.7597
Endoscopic management of difficult common bile duct stones: Where are we now? A comprehensive review
Alberto Tringali, Deborah Costa, Alessandro Fugazza, Matteo Colombo, Kareem Khalaf, Alessandro Repici, Andrea Anderloni
Alberto Tringali, Deborah Costa, Gastroenterology and Endoscopy Unit, Department of Medicine, Conegliano Hospital, ULSS 2 Marca Trevigiana, Conegliano 31015, Italy
Alessandro Fugazza, Matteo Colombo, Alessandro Repici, Andrea Anderloni, Digestive Endoscopy Unit, Department of Gastroenterology, Humanitas Research Hospital IRCCS, Rozzano 20089, Milan, Italy
Kareem Khalaf, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele 20072, Milan, Italy
Author contributions: Anderloni A conceived the idea for the manuscript; Tringali A and Costa D reviewed the literature and drafted the manuscript; Fugazza A, Colombo M, Khalaf K and Repici A reviewed the manuscript.
Conflict-of-interest statement: Alessandro Fugazza is a consultant of Boston Scientific and Olympus; Alessandro Repici is a consultant of Boston Scientific, Fujifilm and ERBE; Andrea Anderloni is a consultant of Boston Scientific, Olympus and Medtronic; No others conflict of interest for the remaining authors.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Alberto Tringali, MD, Director, Doctor, Gastroenterology and Endoscopy Unit, Department of Medicine, Conegliano Hospital, ULSS 2 Marca Trevigiana, Conegliano 31015, Italy. alberto.tringali@aulss2.veneto.it
Received: April 27, 2021
Peer-review started: April 27, 2021
First decision: June 13, 2021
Revised: July 23, 2021
Accepted: November 18, 2021
Article in press: November 18, 2021
Published online: November 28, 2021
Core Tip

Core Tip: The endoscopic management of difficult common bile (CBD) stones remains a challenge, whilst emerging techniques such as endoscopic sphincterotomy and large balloon dilation, mechanical lithotripsy and intraductal lithotripsy provide a procedural indication that align with the patient’s condition, comorbidities, feature of the CBD stone and the patient’s anatomical features. This review focuses on comprehensively outlining a stepwise approach for the management of difficult CBD stones and comparatively discusses indications depending on surgical altered anatomy and future indications in the management of difficult CBD stones.