Alternative methods in the management of bile duct stones

Common bile duct stones may now be dealt with, in most cases, without the need for surgery. To be sure, surgery continues to remain the gold standard for duct clearance and treatment of biliary sepsis. Improvements in endoscopic and radiologic technology and methodology have permitted excellent access to the biliary tree by the transduodenal and transhepatic approaches. In the majority of patients, total duct clearance and excellent drainage can be accomplished, averting sepsis and the need for open surgery.