Related Experiment Video

Updated: Apr 9, 2026

Laparoscopic Common Bile Duct Exploration Followed by Primary Suture Using a Modified Bile Duct Incision
05:36

Laparoscopic Common Bile Duct Exploration Followed by Primary Suture Using a Modified Bile Duct Incision

Published on: May 2, 2025

877

Clinical Features and Outcomes of Endoscopic Treatment for Stones in Stemware-Shaped Common Bile Ducts: A Multicenter

Jee Young Han1,2, Don Haeng Lee1,3, Seok Jeong1,3

  • 1Department of Internal Medicine, Inha University Hospital, Incheon, Korea.

Gut and Liver
|June 20, 2015
PubMed

Insights

Endoscopic treatment of common bile duct (CBD) stones in stemware-shaped anatomy is challenging, with a low initial success rate. Careful pre-procedure assessment is crucial for managing these difficult CBD stones.

Area of Science:

  • Gastroenterology
  • Hepatobiliary Surgery
  • Endoscopic Procedures

Background:

  • Anatomical variations in the biliary tree, specifically stemware-shaped common bile ducts (CBDs), present unique challenges for the removal of difficult gallstones.
  • Effective management strategies for CBD stones in these challenging anatomical configurations are crucial for patient outcomes.

Purpose of the Study:

  • To evaluate the clinical characteristics and outcomes of endoscopic treatment for gallstones located within stemware-shaped CBDs.
  • To identify factors influencing the success and complications of these procedures.

Main Methods:

  • Retrospective analysis of 34 patients with stemware-shaped CBDs and gallstones treated between January 2008 and December 2012.
  • First-line endoscopic treatment was assessed, with second-line procedures including percutaneous or direct peroral cholangioscopy, endoscopic retrograde biliary drainage, or surgery for treatment failures.

Main Results:

  • The overall success rate for the initial endoscopic procedure was 41.2%.
  • Mechanical lithotripsy was necessary in 38.2% of patients, and 58.8% required a second-line intervention.
  • Complications occurred in 14.7% of patients, with no procedure-related mortality.

Conclusions:

  • Endoscopic management of gallstones in stemware-shaped CBDs is associated with significant challenges and a lower success rate.
  • Thorough pre-procedural evaluation is essential for optimizing treatment strategies and patient selection for these difficult cases.
Abstract

Keywords:
Cholangiopancreatography, endoscopic retrogradeCholedocholithiasisCommon bile ductMechanical lithotripsy

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