Non-operative Management of Common Bile Duct Stones: ERCP and Other Techniques (Lithotripsy)

  • Andrew T. Strong
  • Jeffrey L. PonskyEmail author


For decades, when common bile ducts stones were suspected, palpated, or demonstrated by operative cholangiography, formal choledochotomy and bile duct exploration were the preferred approach for their removal. Since the introduction of endoscopic retrograde cholangiopancreatography (ERCP), the management of choledocholithiasis has increasingly become a non-operative endeavor. The current literature demonstrates that non-operative management has far greater than 90% efficacy. In this chapter we discuss some of the basic principles of ERCP and address adjunctive maneuvers and techniques to evacuate stones and debris from the common bile duct. We also discuss percutaneous, and hybrid techniques, particularly useful when ERCP fails. Finally we look toward the horizon and other techniques and technologies that may become more common place in the future.


Choledocholithiasis Endoscopic retrograde cholangiopancreatography (ERCP) Cholangiogram Endoscopy Sphincterotomy Sphincteroplasty Lithotripsy Percutaneous transhepatic cholangiocatheter (PTC) Rendezvous 


  1. 1.
    Tazuma S. Gallstone disease: epidemiology, pathogenesis, and classification of biliary stones (common bile duct and intrahepatic). Best Pract Res Clin Gastroenterol. 2006;20(6):1075–83.PubMedCrossRefPubMedCentralGoogle Scholar
  2. 2.
    Tazuma S, Kanno K, Sugiyama A, Kishikawa N. Nutritional factors (nutritional aspects) in biliary disorders: bile acid and lipid metabolism in gallstone diseases and pancreaticobiliary maljunction. J Gastroenterol Hepatol. 2013;28(Suppl 4):103–7.PubMedCrossRefPubMedCentralGoogle Scholar
  3. 3.
    Everhart JE, Ruhl CE. Burden of digestive diseases in the United States part I: overall and upper gastrointestinal diseases. Gastroenterology. 2009;136(2):376–86.PubMedCrossRefPubMedCentralGoogle Scholar
  4. 4.
    Videhult P, Sandblom G, Rasmussen IC. How reliable is intraoperative cholangiography as a method for detecting common bile duct stones?: a prospective population-based study on 1171 patients. Surg Endosc. 2009;23(2):304–12.PubMedCrossRefPubMedCentralGoogle Scholar
  5. 5.
    Williams E, Beckingham I, El Sayed G, Gurusamy K, Sturgess R, Webster G, et al. Updated guideline on the management of common bile duct stones (CBDS). Gut. 2017;66(5):765–82.PubMedCrossRefPubMedCentralGoogle Scholar
  6. 6.
    Maple JT, Ikenberry SO, Anderson MA, Appalaneni V, Decker GA, Early D, et al. The role of endoscopy in the management of choledocholithiasis. Gastrointest Endosc. 2011;74(4):731–44.PubMedCrossRefPubMedCentralGoogle Scholar
  7. 7.
    Oría A, Alvarez J, Chiapetta L, Fontana JJ, Iovaldi M, Paladino A, et al. Risk factors for acute pancreatitis in patients with migrating gallstones. Arch Surg. 1989;124(11):1295–6.PubMedCrossRefPubMedCentralGoogle Scholar
  8. 8.
    Frossard JL, Hadengue A, Amouyal G, Choury A, Marty O, Giostra E, et al. Choledocholithiasis: a prospective study of spontaneous common bile duct stone migration. Gastrointest Endosc. 2000;51(2):175–9.PubMedCrossRefPubMedCentralGoogle Scholar
  9. 9.
    Cox MR, Budge JPO, Eslick GD. Timing and nature of presentation of unsuspected retained common bile duct stones after laparoscopic cholecystectomy: a retrospective study. Surg Endosc. 2015;29(7):2033–8.PubMedCrossRefPubMedCentralGoogle Scholar
  10. 10.
    Scientific Committee of the European Association for Endoscopic Surgery (E.A.E.S.). Diagnosis and treatment of common bile duct stones (CBDS). Results of a consensus development conference. Surg Endosc. 1998;12(6):856–64.CrossRefGoogle Scholar
  11. 11.
    Raymondos K, Panning B, Bachem I, Manns MP, Piepenbrock S, Meier PN. Evaluation of endoscopic retrograde cholangiopancreatography under conscious sedation and general anesthesia. Endoscopy. 2002;34(9):721–6.PubMedCrossRefPubMedCentralGoogle Scholar
  12. 12.
    Buxbaum J, Roth N, Motamedi N, Lee T, Leonor P, Salem M, et al. Anesthetist-directed sedation favors success of advanced endoscopic procedures. Am J Gastroenterol. 2017;112(2):290–6.PubMedCrossRefPubMedCentralGoogle Scholar
  13. 13.
    Lichtenstein DR, Jagannath S, Baron TH, Anderson MA, Banerjee S, Dominitz JA, et al. Sedation and anesthesia in GI endoscopy. Gastrointest Endosc. 2008;68(5):815–26.PubMedCrossRefPubMedCentralGoogle Scholar
  14. 14.
    Dumonceau J-M, Riphaus A, Schreiber F, Vilmann P, Beilenhoff U, Aparicio JR, et al. Non-anesthesiologist administration of propofol for gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates Guideline – updated June 2015. Endoscopy. 2015;47(12):1175–89.PubMedCrossRefPubMedCentralGoogle Scholar
  15. 15.
    Tringali A, Mutignani M, Milano A, Perri V, Costamagna G. No difference between supine and prone position for ERCP in conscious sedated patients: a prospective randomized study. Endoscopy. 2008;40(2):93–7.PubMedCrossRefPubMedCentralGoogle Scholar
  16. 16.
    ASGE Standards of Practice Committee, Khashab MA, Chithadi KV, Acosta RD, Bruining DH, Chandrasekhara V, et al. Antibiotic prophylaxis for GI endoscopy. Gastrointest Endosc. 2015;81(1):81–9.CrossRefGoogle Scholar
  17. 17.
    McCune WS, Shorb PE, Moscovitz H. Endoscopic cannulation of the ampulla of vater: a preliminary report. Ann Surg. 1968;167(5):752–6.PubMedPubMedCentralCrossRefGoogle Scholar
  18. 18.
    McHenry L, Lehman G. Chapter 1: Four decades: the history of ERCP. In: Baron TH, Kozarek RA, Carr-Locke D, editors. ERCP. 2nd ed. Philadelphia: Saunders Elsevier; 2013. p. 2–9.Google Scholar
  19. 19.
    Zimmon DS, Falkenstein DB, Kessler RE. Endoscopic papillotomy for choledocholithiasis. N Engl J Med. 1975;293(23):1181–2.PubMedCrossRefPubMedCentralGoogle Scholar
  20. 20.
    Testoni PA, Mariani A, Aabakken L, Arvanitakis M, Bories E, Costamagna G, et al. Papillary cannulation and sphincterotomy techniques at ERCP: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy. 2016;48(7):657–83.PubMedCrossRefPubMedCentralGoogle Scholar
  21. 21.
    Bourke MJ, Costamagna G, Freeman ML. Biliary cannulation during endoscopic retrograde cholangiopancreatography: core technique and recent innovations. Endoscopy. 2009;41(7):612–7.PubMedCrossRefPubMedCentralGoogle Scholar
  22. 22.
    Laasch H-U, Tringali A, Wilbraham L, Marriott A, England RE, Mutignani M, et al. Comparison of standard and steerable catheters for bile duct cannulation in ERCP. Endoscopy. 2003;35(8):669–74.PubMedCrossRefPubMedCentralGoogle Scholar
  23. 23.
    Tse F, Yuan Y, Moayyedi P, Leontiadis GI. Guide wire-assisted cannulation for the prevention of post-ERCP pancreatitis: a systematic review and meta-analysis. Endoscopy. 2013;45(8):605–18.PubMedCrossRefPubMedCentralGoogle Scholar
  24. 24.
    Navaneethan U, Konjeti R, Venkatesh PG, Sanaka MR, Parsi MA. Early precut sphincterotomy and the risk of endoscopic retrograde cholangiopancreatography related complications: an updated meta-analysis. World J Gastrointest Endosc. 2014;6(5):200–8.PubMedPubMedCentralCrossRefGoogle Scholar
  25. 25.
    Choudhary A, Winn J, Siddique S, Arif M, Arif Z, Hammoud GM, et al. Effect of precut sphincterotomy on post-endoscopic retrograde cholangiopancreatography pancreatitis: a systematic review and meta-analysis. World J Gastroenterol. 2014;20(14):4093–101.PubMedPubMedCentralCrossRefGoogle Scholar
  26. 26.
    Neuhaus H. Chapter 16: Biliary sphincterotomy. In: ERCP. 2nd ed. Philadelphia: Saunders Elsevier; 2013. p. 129–40.CrossRefGoogle Scholar
  27. 27.
    Staritz M, Ewe K, Meyer zum Büschenfelde KH. Endoscopic papillary dilation (EPD) for the treatment of common bile duct stones and papillary stenosis. Endoscopy. 1983;15(Suppl 1):197–8.PubMedCrossRefPubMedCentralGoogle Scholar
  28. 28.
    Liao W-C, Tu Y-K, Wu M-S, Wang H-P, Lin J-T, Leung JW, et al. Balloon dilation with adequate duration is safer than sphincterotomy for extracting bile duct stones: a systematic review and meta-analyses. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2012;10(10):1101–9.Google Scholar
  29. 29.
    Weinberg BM, Shindy W, Lo S. Endoscopic balloon sphincter dilation (sphincteroplasty) versus sphincterotomy for common bile duct stones. Cochrane Database Syst Rev. 2006;(4):CD004890.Google Scholar
  30. 30.
    Zhao H-C, He L, Zhou D-C, Geng X-P, Pan F-M. Meta-analysis comparison of endoscopic papillary balloon dilatation and endoscopic sphincteropapillotomy. World J Gastroenterol. 2013;19(24):3883–91.PubMedPubMedCentralCrossRefGoogle Scholar
  31. 31.
    Liu Y, Su P, Lin S, Xiao K, Chen P, An S, et al. Endoscopic papillary balloon dilatation versus endoscopic sphincterotomy in the treatment for choledocholithiasis: a meta-analysis. J Gastroenterol Hepatol. 2012;27(3):464–71.PubMedCrossRefPubMedCentralGoogle Scholar
  32. 32.
    Baron TH, Harewood GC. Endoscopic balloon dilation of the biliary sphincter compared to endoscopic biliary sphincterotomy for removal of common bile duct stones during ERCP: a metaanalysis of randomized, controlled trials. Am J Gastroenterol. 2004;99(8):1455–60.PubMedCrossRefPubMedCentralGoogle Scholar
  33. 33.
    Kim TH, Kim JH, Seo DW, Lee DK, Reddy ND, Rerknimitr R, et al. International consensus guidelines for endoscopic papillary large-balloon dilation. Gastrointest Endosc. 2016;83(1):37–47.PubMedCrossRefPubMedCentralGoogle Scholar
  34. 34.
    Wang AY. Reappraisal of endoscopic papillary balloon dilation versus sphincterotomy for choledocholithiasis-time for a new trial. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2017;15(11):1671–3.Google Scholar
  35. 35.
    Kim JH, Yang MJ, Hwang JC, Yoo BM. Endoscopic papillary large balloon dilation for the removal of bile duct stones. World J Gastroenterol. 2013;19(46):8580–94.PubMedPubMedCentralCrossRefGoogle Scholar
  36. 36.
    Seitz U, Bapaye A, Bohnacker S, Navarrete C, Maydeo A, Soehendra N. Advances in therapeutic endoscopic treatment of common bile duct stones. World J Surg. 1998;22(11):1133–44.PubMedCrossRefPubMedCentralGoogle Scholar
  37. 37.
    Leung JW, Tu R. Mechanical lithotripsy for large bile duct stones. Gastrointest Endosc. 2004;59(6):688–90.PubMedCrossRefPubMedCentralGoogle Scholar
  38. 38.
    Patel SN, Rosenkranz L, Hooks B, Tarnasky PR, Raijman I, Fishman DS, et al. Holmium-yttrium aluminum garnet laser lithotripsy in the treatment of biliary calculi using single-operator cholangioscopy: a multicenter experience (with video). Gastrointest Endosc. 2014;79(2):344–8.PubMedCrossRefPubMedCentralGoogle Scholar
  39. 39.
    Sauer BG, Cerefice M, Swartz DC, Gaidhane M, Jain A, Haider S, et al. Safety and efficacy of laser lithotripsy for complicated biliary stones using direct choledochoscopy. Dig Dis Sci. 2013;58(1):253–6.PubMedCrossRefPubMedCentralGoogle Scholar
  40. 40.
    Binmoeller KF, Brückner M, Thonke F, Soehendra N. Treatment of difficult bile duct stones using mechanical, electrohydraulic and extracorporeal shock wave lithotripsy. Endoscopy. 1993;25(3):201–6.PubMedCrossRefPubMedCentralGoogle Scholar
  41. 41.
    Riemann JF, Seuberth K, Demling L. Mechanical lithotripsy of common bile duct stones. Gastrointest Endosc. 1985;31(3):207–10.PubMedCrossRefPubMedCentralGoogle Scholar
  42. 42.
    Garg PK, Tandon RK, Ahuja V, Makharia GK, Batra Y. Predictors of unsuccessful mechanical lithotripsy and endoscopic clearance of large bile duct stones. Gastrointest Endosc. 2004;59(6):601–5.PubMedCrossRefPubMedCentralGoogle Scholar
  43. 43.
    Shaw MJ, Mackie RD, Moore JP, Dorsher PJ, Freeman ML, Meier PB, et al. Results of a multicenter trial using a mechanical lithotripter for the treatment of large bile duct stones. Am J Gastroenterol. 1993;88(5):730–3.PubMedPubMedCentralGoogle Scholar
  44. 44.
    Trikudanathan G, Arain MA, Attam R, Freeman ML. Advances in the endoscopic management of common bile duct stones. Nat Rev Gastroenterol Hepatol. 2014;11(9):535–44.PubMedCrossRefPubMedCentralGoogle Scholar
  45. 45.
    Siegel JH, Ben-Zvi JS, Pullano WE. Endoscopic electrohydraulic lithotripsy. Gastrointest Endosc. 1990;36(2):134–6.PubMedCrossRefPubMedCentralGoogle Scholar
  46. 46.
    Kamiyama R, Ogura T, Okuda A, Miyano A, Nishioka N, Imanishi M, et al. Electrohydraulic lithotripsy for difficult bile duct stones under endoscopic retrograde cholangiopancreatography and peroral transluminal cholangioscopy guidance. Gut Liver. 2018;12:457–62.PubMedPubMedCentralCrossRefGoogle Scholar
  47. 47.
    Bhandari S, Sanghvi K, Sharma A, Bondade N, Maydeo A. Single-operator cholangioscopy-guided holmium laser lithotripsy: the new-age “rescue” lithotripsy. Gastrointest Endosc. 2016;83(5):1035–6.PubMedCrossRefPubMedCentralGoogle Scholar
  48. 48.
    Lv S, Fang Z, Wang A, Yang J, Zhang W. Choledochoscopic holmium laser lithotripsy for difficult bile duct stones. J Laparoendosc Adv Surg Tech A. 2017;27(1):24–7.PubMedCrossRefPubMedCentralGoogle Scholar
  49. 49.
    Ponsky LE, Geisinger MA, Ponsky JL, Streem SB. Contemporary “urologic” intervention in the pancreaticobiliary tree. Urology. 2001;57(1):21–5.PubMedCrossRefPubMedCentralGoogle Scholar
  50. 50.
    Winick AB, Waybill PN, Venbrux AC. Complications of percutaneous transhepatic biliary interventions. Tech Vasc Interv Radiol. 2001;4(3):200–6.PubMedCrossRefPubMedCentralGoogle Scholar
  51. 51.
    Dowell JD, Weinstein J, Lim A, Guy GE. Chapter 9: Percutaneous methods of common bile duct stone retrieval. In: Hazey JW, Conwell D, Guy GE, editors. Multidisciplinary management of common duct stones. Cham: Springer International Publishing; 2016. p. 77–83.CrossRefGoogle Scholar
  52. 52.
    Ozcan N, Kahriman G, Mavili E. Percutaneous transhepatic removal of bile duct stones: results of 261 patients. Cardiovasc Intervent Radiol. 2012;35(4):890–7.PubMedCrossRefPubMedCentralGoogle Scholar
  53. 53.
    Centola CA, Jander HP, Stauffer A, Russinovich NA. Balloon dilatation of the papilla of Vater to allow biliary stone passage. AJR Am J Roentgenol. 1981;136(3):613–4.PubMedCrossRefPubMedCentralGoogle Scholar
  54. 54.
    Kint JF, van den Bergh JE, van Gelder RE, Rauws EA, Gouma DJ, van Delden OM, et al. Percutaneous treatment of common bile duct stones: results and complications in 110 consecutive patients. Dig Surg. 2015;32(1):9–15.PubMedCrossRefPubMedCentralGoogle Scholar
  55. 55.
    Rimon U, Kleinmann N, Bensaid P, Golan G, Garniek A, Khaitovich B, et al. Percutaneous transhepatic endoscopic holmium laser lithotripsy for intrahepatic and choledochal biliary stones. Cardiovasc Intervent Radiol. 2011;34(6):1262–6.PubMedCrossRefPubMedCentralGoogle Scholar
  56. 56.
    Schatloff O, Rimon U, Garniek A, Lindner U, Morag R, Mor Y, et al. Percutaneous transhepatic lithotripsy with the holmium: YAG laser for the treatment of refractory biliary lithiasis. Surg Laparosc Endosc Percutan Tech. 2009;19(2):106–9.PubMedCrossRefPubMedCentralGoogle Scholar
  57. 57.
    Mo LR, Hwang MH, Yueh SK, Yang JC, Lin C. Percutaneous transhepatic choledochoscopic electrohydraulic lithotripsy (PTCS-EHL) of common bile duct stones. Gastrointest Endosc. 1988;34(2):122–5.PubMedCrossRefPubMedCentralGoogle Scholar
  58. 58.
    Gil S, de la Iglesia P, Verdú JF, de España F, Arenas J, Irurzun J. Effectiveness and safety of balloon dilation of the papilla and the use of an occlusion balloon for clearance of bile duct calculi. AJR Am J Roentgenol. 2000;174(5):1455–60.PubMedCrossRefPubMedCentralGoogle Scholar
  59. 59.
    García-García L, Lanciego C. Percutaneous treatment of biliary stones: sphincteroplasty and occlusion balloon for the clearance of bile duct calculi. Am J Roentgenol. 2004;182(3):663–70.CrossRefGoogle Scholar
  60. 60.
    Isayama H, Yasuda I, Tan D. Current strategies for endoscopic management of acute cholangitis. Dig Endosc Off J Jpn Gastroenterol Endosc Soc. 2017;29(Suppl 2):70–7.Google Scholar
  61. 61.
    Yang J, Peng J, Chen W. Endoscopic biliary stenting for irretrievable common bile duct stones: indications, advantages, disadvantages, and follow-up results. Surg J R Coll Surg Edinb Irel. 2012;10(4):211–7.Google Scholar
  62. 62.
    Di Giorgio P, Manes G, Grimaldi E, Schettino M, D’Alessandro A, Di Giorgio A, et al. Endoscopic plastic stenting for bile duct stones: stent changing on demand or every 3 months. A prospective comparison study. Endoscopy. 2013;45(12):1014–7.PubMedCrossRefPubMedCentralGoogle Scholar
  63. 63.
    Ponsky JL. Endoscopic management of common bile duct stones. World J Surg. 1992;16(6):1060–5.PubMedCrossRefPubMedCentralGoogle Scholar
  64. 64.
    DeIorio AV, Vitale GC, Reynolds M, Larson GM. Acute biliary pancreatitis. The roles of laparoscopic cholecystectomy and endoscopic retrograde cholangiopancreatography. Surg Endosc. 1995;9(4):392–6.PubMedCrossRefPubMedCentralGoogle Scholar
  65. 65.
    Cotton PB. Endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy. Am J Surg. 1993;165(4):474–8.PubMedCrossRefPubMedCentralGoogle Scholar
  66. 66.
    Davis WZ, Cotton PB, Arias R, Williams D, Onken JE. ERCP and sphincterotomy in the context of laparoscopic cholecystectomy: academic and community practice patterns and results. Am J Gastroenterol. 1997;92(4):597–601.PubMedPubMedCentralGoogle Scholar
  67. 67.
    Cotton PB. Endoscopic management of bile duct stones; (apples and oranges). Gut. 1984;25(6):587–97.PubMedPubMedCentralCrossRefGoogle Scholar
  68. 68.
    Stain SC, Cohen H, Tsuishoysha M, Donovan AJ. Choledocholithiasis. Endoscopic sphincterotomy or common bile duct exploration. Ann Surg. 1991;213(6):627–33; discussion 633–634.PubMedPubMedCentralCrossRefGoogle Scholar
  69. 69.
    Cuschieri A, Croce E, Faggioni A, Jakimowicz J, Lacy A, Lezoche E, et al. EAES ductal stone study. Preliminary findings of multi-center prospective randomized trial comparing two-stage vs single-stage management. Surg Endosc. 1996;10(12):1130–5.PubMedCrossRefPubMedCentralGoogle Scholar
  70. 70.
    Cotton PB, Lehman G, Vennes J, Geenen JE, Russell RC, Meyers WC, et al. Endoscopic sphincterotomy complications and their management: an attempt at consensus. Gastrointest Endosc. 1991;37(3):383–93.PubMedPubMedCentralCrossRefGoogle Scholar
  71. 71.
    Deslandres E, Gagner M, Pomp A, Rheault M, Leduc R, Clermont R, et al. Intraoperative endoscopic sphincterotomy for common bile duct stones during laparoscopic cholecystectomy. Gastrointest Endosc. 1993;39(1):54–8.PubMedCrossRefPubMedCentralGoogle Scholar
  72. 72.
    Curet MJ, Pitcher DE, Martin DT, Zucker KA. Laparoscopic antegrade sphincterotomy. A new technique for the management of complex choledocholithiasis. Ann Surg. 1995;221(2):149–55.PubMedPubMedCentralCrossRefGoogle Scholar
  73. 73.
    Rhodes M, Nathanson L, O’Rourke N, Fielding G. Laparoscopic antegrade biliary stenting. Endoscopy. 1995;27(9):676–8.PubMedCrossRefPubMedCentralGoogle Scholar
  74. 74.
    Leppard WM, Shary TM, Adams DB, Morgan KA. Choledochoduodenostomy: is it really so bad? J Gastrointest Surg Off J Soc Surg Aliment Tract. 2011;15(5):754–7.CrossRefGoogle Scholar
  75. 75.
    Qadan M, Clarke S, Morrow E, Triadafilopoulos G, Visser B. Sump syndrome as a complication of choledochoduodenostomy. Dig Dis Sci. 2012;57(8):2011–5.PubMedCrossRefPubMedCentralGoogle Scholar
  76. 76.
    Abraham H, Thomas S, Srivastava A. Sump syndrome: a rare long-term complication of choledochoduodenostomy. Case Rep Gastroenterol. 2017;11(2):428–33.PubMedPubMedCentralCrossRefGoogle Scholar
  77. 77.
    Tomizawa Y, Di Giorgio J, Santos E, McCluskey KM, Gelrud A. Combined interventional radiology followed by endoscopic therapy as a single procedure for patients with failed initial endoscopic biliary access. Dig Dis Sci. 2014;59(2):451–8.PubMedCrossRefPubMedCentralGoogle Scholar
  78. 78.
    Kawakami H, Abo D, Kawakubo K, Kuwatani M, Yoshino Y, Kubota Y, et al. Rendezvous biliary recanalization combining percutaneous and endoscopic techniques using a diathermic dilator for bile duct obstruction. Endoscopy. 2014;46 Suppl 1 UCTN:E460–1.PubMedPubMedCentralGoogle Scholar
  79. 79.
    Tzovaras G, Baloyiannis I, Kapsoritakis A, Psychos A, Paroutoglou G, Potamianos S. Laparoendoscopic rendezvous: an effective alternative to a failed preoperative ERCP in patients with cholecystocholedocholithiasis. Surg Endosc. 2010;24(10):2603–6.PubMedCrossRefPubMedCentralGoogle Scholar
  80. 80.
    La Barba G, Gardini A, Cavargini E, Casadei A, Morgagni P, Bazzocchi F, et al. Laparoendoscopic rendezvous in the treatment of cholecysto-choledocholitiasis: a single series of 200 patients. Surg Endosc. 2018Google Scholar
  81. 81.
    Tyberg A, Desai AP, Kumta NA, Brown E, Gaidhane M, Sharaiha RZ, et al. EUS-guided biliary drainage after failed ERCP: a novel algorithm individualized based on patient anatomy. Gastrointest Endosc. 2016;84(6):941–6.PubMedCrossRefPubMedCentralGoogle Scholar
  82. 82.
    Wang K, Zhu J, Xing L, Wang Y, Jin Z, Li Z. Assessment of efficacy and safety of EUS-guided biliary drainage: a systematic review. Gastrointest Endosc. 2016;83(6):1218–27.PubMedCrossRefPubMedCentralGoogle Scholar
  83. 83.
    Iwashita T, Yasuda I, Doi S, Uemura S, Mabuchi M, Okuno M, et al. Endoscopic ultrasound-guided antegrade treatments for biliary disorders in patients with surgically altered anatomy. Dig Dis Sci. 2013;58(8):2417–22.PubMedCrossRefPubMedCentralGoogle Scholar
  84. 84.
    Nakai Y, Kogure H, Yamada A, Isayama H, Koike K. Endoscopic management of bile duct stones in patients with surgically altered anatomy. Dig Endosc Off J Jpn Gastroenterol Endosc Soc. 2018;30(Suppl 1):67–74.Google Scholar
  85. 85.
    Yamauchi H, Kida M, Imaizumi H, Okuwaki K, Miyazawa S, Iwai T, et al. Innovations and techniques for balloon-enteroscope-assisted endoscopic retrograde cholangiopancreatography in patients with altered gastrointestinal anatomy. World J Gastroenterol. 2015;21(21):6460–9.PubMedPubMedCentralCrossRefGoogle Scholar
  86. 86.
    Sauerbruch T, Delius M, Paumgartner G, Holl J, Wess O, Weber W, et al. Fragmentation of gallstones by extracorporeal shock waves. N Engl J Med. 1986;314(13):818–22.PubMedCrossRefPubMedCentralGoogle Scholar
  87. 87.
    Amplatz S, Piazzi L, Felder M, Comberlato M, Benvenuti S, Zancanella L, et al. Extracorporeal shock wave lithotripsy for clearance of refractory bile duct stones. Dig Liver Dis Off J Ital Soc Gastroenterol Ital Assoc Study Liver. 2007;39(3):267–72.Google Scholar

Copyright information

© Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 2020

Authors and Affiliations

  1. 1.Department of General SurgeryDigestive Disease and Surgery Institute, Cleveland ClinicClevelandUSA
  2. 2.Department of SurgeryCleveland Clinic Lerner College of Medicine of Case Western Reserve UniversityClevelandUSA

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