علاج تحص القناة الصفراوية مع حصوات القناة الصفراوية المشتركة التي يزيد قطرها عن 1.5 سم أو ذات تشريح صعب

References

• The criteria for difficult gallstones are as follows: diameter over 1.5 cm, barrel-shaped, sigmoid or located in the cystic and intrahepatic ducts, and stone impaction, as shown in Figure 8.
• Predicted failed extraction by sphincterotomy + balloon and/or basket (stone size >1.5 cm, multiple stones, narrow distal CBD, angled CBD)
• In these difficult gallstone cases, dilation of the bile duct uses endoscopic papillary large balloon dilation (EPLBD).
• This procedure is done after endoscopic sphincterotomy.