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Updated: Jun 11, 2026

Laparoscopic Common Bile Duct Exploration Followed by Primary Suture Using a Modified Bile Duct Incision
Published on: May 2, 2025
Endoscopic management of bile duct stones
1Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan. itoi@tokyo-med.ac.jp
Abstract:
Endoscopic sphincterotomy (EST) and endoscopic papillary balloon dilation (EPBD) are endoscopic techniques that are used for the removal of bile duct stones. Although EST and EPBD have become established techniques, occasionally the management of bile duct stones may be difficult in cases of large stones, multiple stones, and tapering or tortuosity of the distal common bile duct. In such patients, extracorporeal shock wave lithotripsy, mechanical lithotripsy or electrohydraulic lithotripsy, laser lithotripsy, or surgical intervention may be necessary. Furthermore, recently EST plus a large papillary balloon dilation has been popular for the treatment of difficult bile duct stones. Currently, endoscopic lithotripsy for bile duct stones seems to be a promising standard technique.
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