علاج تحصيات الغدة النكفية مع وجود حجر في الحليمة أو القناة الإخراجية البعيدة

References

DOI: 10.1007/s00405-025-09697-y

• Stones in the Papilla and Distal Excretory Duct
• Mobile stones not exceeding 3–5 mm in size are an ideal indication for extraction with intSE using instruments such as a basket or forceps, if necessary after application of ISWL.
• Endoscopic mobilization or fragmentation is indicated for stones 5–7 mm in size.
• If the stones have a weak consistency, mechanical fragmentation using microdrills is a possible solution in some cases.
• However, in general, in particular if the stones are of a hard consistency and/or are greater than 7 mm, ISWL represents an excellent treatment modality with high success rates.
• Major changes from the earlier algorithm are the fact that intSE or ISWL are the first choice if the anatomy of the duct system permits.