Contemporary approaches in the diagnosis and management of choledocholithiasis

Abstract

Introduction. Choledocholithiasis, also known as common bile duct stones, is a common condition characterized by the presence of gallstones in the common bile duct. Diagnostic modalities for choledocholithiasis include ultrasound, magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography. The management of choledocholithiasis necessitates a multidisciplinary approach, encompassing medical therapy, endoscopic interventions, and surgical treatment, with the choice contingent on various factors. Aim of study. To conduct a contemporary literature review and elucidate various factors for treating patients with choledocholithiasis. Methods and materials. Multiple articles from the PubMed database have been reviewed over a span of ten years. Results. The treatment of choledocholithiasis primarily involves the removal of obstructing stones through endoscopic procedures. Endoscopic retrograde cholangiopancreatography, typically performed in the prone position, allows the insertion of a duodenoscope into the duodenum, advancing a catheter and guidewire into the common bile duct. Using a sphincterotome, the papilla is cut with cautery, enlarging the ampulla of Vater to release stones. Various tools, such as snares and baskets, aid in stone removal, and a balloon catheter can sweep the common bile duct. Surgical removal is indicated for large, stuck, or numerous stones, requiring laparoscopic or open common bile duct exploration. An elective cholecystectomy during the same admission prevents future choledocholithiasis episodes. Conclusion. The focus of choledocholithiasis treatment revolves mainly around a minimally invasive approach. Treatment factors involve using tools for stone removal, sphincterotomy, balloon catheterization, and stent placement to manage remaining stones and prevent obstructive jaundice. condition characterized by the presence of gallstones in t he common bile duct. Diagnostic modalities for choledocholithiasis include ultrasound, magneti c resonance cholangiopancreatography and endoscopic retrograde cholangi opancreatography. The management of choledocholithiasis necessitates a multi disciplinary approach, encompassing medical therapy, endoscopic interventions, and surgical treatment, with the choice contingent on various factors. Aim of study. To conduct a contemporary literature review and elucidate var ious factors for treating patients with choledocholithiasis. Methods and materials. Multiple articles from the PubMed database have been r eviewed over a span of ten years. Results. The treatment of choledocholithiasis primarily involves the removal of obstructing stones through endoscopic procedures. Endoscopic retrograde cholangio pancreatography, typically performed in the prone position, allows the insertion of a duodenoscope into the duodenum, advancing a catheter and guidewire into the common bile duct. Using a sphincterotome, the papilla is cut with cautery, enlarging the ampulla of Vater to rel ease stones. Various tools, such as snares and baskets, aid in stone removal, and a balloon catheter can sweep the common bile duct. Surgical removal is indicated for large, stuck, or numerous stones, requiring laparoscopic or open common bile duct exploration. An elective cholecystectomy during the s ame admission prevents future choledocholithiasis episodes. Conclusion. The focus of choledocholithiasis treatment revolves m ainly around a minimally invasive approach. Treatment factors involve using tools for s tone removal, sphincterotomy, balloon catheterization, and stent placement to manage re maining stones and prevent obstructive jaundice.