[The current aspects of treating residual choledocholithiasis]

Area of Science:

• Gastroenterology
• Surgical Endoscopy
• Biliary Tract Diseases

Background:

• Residual calculosis of the common bile duct presents a significant clinical challenge.
• Noninvasive treatment methods for common bile duct stones have evolved over the past 20-30 years.
• Endoscopic papillotomy has emerged as a key intervention for managing residual common bile duct stones.

Observation:

• The study analyzes noninvasive treatment modalities for residual common bile duct calculosis.
• Data from literature and clinical experience with 12 patients (3 noninvasively treated, 9 endoscopically treated) were evaluated.
• Comparative analysis included experience from 984 patients who underwent endoscopic papillotomy.

Findings:

• Endoscopic papillotomy with calculi extraction is preferred over operative treatment for residual common bile duct calculosis, adhering to specific indications.
• Excellent therapeutic outcomes were reported: 1.52% early complications, 1% late complications, 0.4% ineffectiveness, and 0.6% case fatality rate.
• This endoscopic approach offers limited contraindications and the possibility for operative correction.

Implications:

• Endoscopic papillotomy represents a safe and effective treatment for residual common bile duct stones.
• The findings support the widespread adoption of endoscopic papillotomy for this condition.
• Further research may focus on refining indications and optimizing outcomes for endoscopic management of biliary calculosis.