علاج تحص قناة الصفراء المشتركة بحصوة قطرها أكبر من 1.5 سم (معايير الحصوات الصعبة)

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)

mechanical lithotripsy, using the method of stone destruction with baskets, then altering the basket's size to be smaller to create relatively high pressure to make the stone's size smaller.

electrohydraulic lithotripsy, which runs electrical pulses through an intermediary liquid medium, which produces shockwaves that can fracture gallstones into relatively smaller ones.

Lithotripsy (as shown in Figure 9) using lasers to make the gallstone size smaller.

extracorporeal shock wave lithotripsy (ESWL) uses electromagnetic waves from outside the body to the target organ, which in this case is the stone in the bile duct, to reduce its size.

Consider mechanical lithotripsy or cholangioscopy-associated lithotripsy or ESWL