| Theme | Treatment of Choledocholithiasis | |
|---|---|---|
| Title | Bile Duct Stone Treatment Strategy | |
| Publish Date | 2017/01 | |
| Author | Yutaka Suzuki | Department of Surgery, Kyorin University School of Medicine |
| Author | Ryota Matsuki | Department of Surgery, Kyorin University School of Medicine |
| Author | Masaharu Kogure | Department of Surgery, Kyorin University School of Medicine |
| Author | Masaaki Yokoyama | Department of Surgery, Kyorin University School of Medicine |
| Author | Tetsuya Nakazato | Department of Surgery, Kyorin University School of Medicine |
| Author | Nobutsugu Abe | Department of Surgery, Kyorin University School of Medicine |
| Author | Hiroyoshi Matsuoka | Department of Surgery, Kyorin University School of Medicine |
| Author | Tadahiko Masaki | Department of Surgery, Kyorin University School of Medicine |
| Author | Toshiyuki Mori | Department of Surgery, Kyorin University School of Medicine |
| Author | Masanori Sugiyama | Department of Surgery, Kyorin University School of Medicine |
| [ Summary ] | Bile duct stone is classified as common bile duct stone and hepatolithiasis. The treatment strategy for bile duct stone was described in the guidelines for clinical practice of cholelithias. In patients with acute cholangitis and/or pancreatitis, stone extraction should be performed after the treatment of cholangitis and pancreatitis. In terms of stone extraction, both endoscopy and surgery are recommended. In Japan, endoscopy is most frequently performed. However, the best procedure for treating particular conditions is recommended in each institute. With regard to hepatolithiasis, minimally invasive treatment such as percutaneous transhepatic cholangioscopic lithotripsy (PTCSL) and endoscopic retrograde cholangiography (ERC) are preferred. Surgery should be performed in cases in which endoscopy failed. Recently, ERC followed by stone extraction has shown increased success. However, the incidence of residual and recurrent stones after ERC followed by stone extraction was higher than in other procedures. | |