ASGE Annual Postgraduate Course: Clinical Challenges and Real-Time Decision Making in GI Endoscopy (On-demand) | May 2023-Session 10 Video Based Lecture 1

Session 10 Video Based Lecture 1 - Managing Bile Duct Stones of All Sizes

Video Transcription

Video Summary

The video transcript discusses the endoscopic management of common bile duct (CBD) stones. The speaker explains that CBD stones come in various sizes and shapes, and their management has evolved over the years. The majority of cases can now be managed with sphincrotomy, large balloon dilation, or balloon sweep and stenting, while 10% require multimodality therapy or cholangioscopy. The speaker presents two cases to demonstrate different techniques for stone removal, including mechanical lithotripsy, basket retrieval, and cholangioscopy with electrohydraulic lithotripsy or laser lithotripsy. The speaker emphasizes the importance of proper sizing of instruments, good biliary sphincrotomy, and post-procedure assessment to ensure complete removal of stones. Multicenter studies have shown the effectiveness and safety of cholangioscopy in difficult cases. The video concludes by reiterating the advantages of non-surgical management and the importance of patient safety.

Asset Subtitle

Shivangi Kothari, MD, FASGE

Keywords

endoscopic management

common bile duct stones

sphincterotomy

balloon dilation

stone removal