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Updated: Apr 29, 2026

Laparoscopic Common Bile Duct Exploration Followed by Primary Suture Using a Modified Bile Duct Incision
Published on: May 2, 2025
Advances in the endoscopic management of common bile duct stones
Guru Trikudanathan1, Mustafa A Arain1, Rajeev Attam1
1Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, MMC 36, 406 Harvard Street SE, Minneapolis, MN 55455, USA.
Abstract:
Extraction of common bile duct stones by endoscopic retrograde cholangiopancreatography generally involves biliary sphincterotomy, endoscopic papillary balloon dilation or a combination of both. Endoscopic papillary large-balloon dilation after sphincterotomy has increased the safety of large stone extraction. Cholangioscopically directed electrohydraulic and laser lithotripsy using single-operator mother-daughter systems or direct peroral cholangioscopy using ultraslim endoscopes are increasingly utilized for the management of refractory stones. In this Review, we focus on advances in endoscopic approaches and techniques, with a special emphasis on management strategies for 'difficult' common bile duct stones.
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