| Theme |
Complications and their Managements for Gastrointestinal Endoscopy |
| Title |
Management of Difficult Common Bile Duct Stones in Peroral Transpapillary Endoscopic Lithotomy (PTEL) |
| Author |
Masatsugu Nakajima |
Department of Gastroenterology, Kyoto Second Red Cross Hospital |
| Author |
Kenjiro Yasuda |
Department of Gastroenterology, Kyoto Second Red Cross Hospital |
| Author |
Eisai Cho |
Department of Gastroenterology, Kyoto Second Red Cross Hospital |
| Author |
Kiyohito Tanaka |
Department of Gastroenterology, Kyoto Second Red Cross Hospital |
| Author |
Kouji Uno |
Department of Gastroenterology, Kyoto Second Red Cross Hospital |
| [ Summary ] |
Peroral transpapillary endoscopic lithotomy (PTEL) with endoscopic sphincterotomy (EST) or endoscopic papillary balloon dilation (EPBD) is a major therapeutic advance in the management of common bile duct stones. A variety of lithotripsy techniques, such as, mechanical basket lithotripsy (MBL), peroral cholangioscopic lithotripsy (PCSL) with electrohydraulic lithotripsy (EHL) or pulse laser lithotripsy (PLL), and extracorporeal shockwave lithotripsy (ESWL) have been developed and are used with this procedure for the management of difficult common bile duct stones. There are, however, still some technical or clinical problems with these techniques. We described various techniques or approaches to circumvent these problems. |