ASGE International Sampler (On-Demand)-Treating Large CBD Stones: Tips and Tricks

Video Transcription

Video Summary

In the video, a Program Director of Advanced Endoscopy Fellowship at the Cleveland Clinic discusses the management of large common bile duct stones. She explains that common bile duct stones can lead to complications such as pancreatitis, cholangitis, or jaundice, and It is important to strive to remove them during endoscopic retrograde cholangiopancreatography (ERCP). The speaker discusses endoscopic papillary balloon dilation as the mainstay for managing these stones, particularly if they are 1 to 2 centimeters in size. She explains the technique and recommends considering factors such as the size of the common bile duct and the appearance of the papilla when choosing the balloon size. The speaker also discusses the use of mechanical lithotripsy, electrohydraulic lithotripsy, and laser lithotripsy for larger stones or stones located above strictures. She emphasizes the importance of proper technique and cautions about potential complications. Additionally, she mentions the role of stents, both fully covered metal stents and plastic stents, as a salvage therapy for cases where complete stone clearance is not achieved. The speaker concludes by summarizing the different treatment options for different stone sizes and locations.

Asset Subtitle

Prabhleen Chahal, MD, FASGE

Keywords

common bile duct stones

endoscopic papillary balloon dilation

mechanical lithotripsy

electrohydraulic lithotripsy

laser lithotripsy

stents