Management of unextractable bile duct stones by endoscopic stenting

Active treatment of common bile duct stones is preferred because life-threatening complications such as suppurative cholangitis or pancreatitis may occur. In patients unfit for surgery endoscopic extraction of the stones is an excellent alternative. In cases with overwhelming difficulties in stone removal, permanent endoscopic biliary stenting gives good results even in the long-term follow-up. In a material consisting 104 patients, collected from own experiences and from the literature, and followed for 3-59 months, no patients developed acute pancreatitis. Seventeen per cent of patients experienced jaundice and 3% (17% of jaundiced) acute cholangitis. These complications could be easily managed with antibiotics and with the exchange of the stent. In only 2% of patients biliary surgery became obligatory.