Choledocholithiasis
ICD-10 K80.5 ICD-11 DC11.6

Choledocholithiasis with Coagulopathy and High Risk of Bleeding from Sphincterotomy

Standard endoscopic management of choledocholithiasis typically involves sphincterotomy. When a patient presents with coagulopathy that significantly elevates the bleeding risk of that procedure, a distinct approach is required — one that addresses biliary drainage and stone extraction while avoiding sphincterotomy.

Clinical Scenario
Coagulopathy with high risk of bleeding from sphincterotomy. In this population, the usual sphincterotomy step cannot be safely performed, and the procedural strategy must be modified accordingly.
Treatment Approach — Partial Overview
An endoscopic balloon-based technique may be used to facilitate biliary drainage and stone extraction in this setting — serving, when necessary, as the sole procedure. Full procedural protocol, sequencing, and decision criteria available via structured access below.
Instant Access to Structured Evidence-Based Regimens
References
  • Figure 6 showed endoscopic balloon dilation, which is also used to help facilitate biliary drainage and stone extraction.
  • However, this may be the sole procedure if coagulopathy is found and patients have high risk of bleeding from sphincterotomy.
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