Published online Jul 16, 2022. doi: 10.4253/wjge.v14.i7.467
Peer-review started: January 20, 2022
First decision: March 25, 2022
Revised: April 11, 2022
Accepted: June 3, 2022
Article in press: June 3, 2022
Published online: July 16, 2022
Gallstone cholangiopancreatitis is a potentially life-threatening pathology which requires quick intervention involving endoscopists, interventional radiologists, anesthesiologists and surgeons in relation to clinical conditions. Treatment possibilities are varied, especially with current progress in advanced endoscopy, interventional radiology, and minimally invasive surgery. The following treatments are available: endoscopic sphincterotomy (ES) with stone extraction followed by laparoscopic cholecystectomy; simultaneous endoscopic stone extraction with laparoscopic cholecystectomy (rendezvous technique); combined laparoscopic cholecystectomy and common bile duct (CBD) exploration; open CBD exploration; ES post-cholecystectomy; percutaneous placement of biliary drains for unstable patients, followed by percutaneous cholangioscopy; and lithotripsy with different approaches, including a laser and balloon dilation of the sphincter of Oddi. Each technique has its strengths and weaknesses, and there is great discussion in the literature on choosing the ideal approach based on the patient’s clinical conditions.
Core Tip: Urgent biliary decompression represents the treatment of gallstone pancreatitis associated with cholangitis. There are different techniques for common bile duct (CBD) clearance. Endoscopic retrograde cholangiopancreatography is not always feasible, as in the case of poor clinical conditions, large stones, or biliodigestive derivations. We analyzed the different approaches for decompression of the CBD in the case of “cholangiopancreatitis”.