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Common bile duct (CBD) stone management has evolved significantly with technological advances and an improved understanding of pathophysiology. This comprehensive review examines current evidence and emerging trends in CBD stone management, emphasizing modern diagnostic approaches and treatment paradigms. Recent developments in imaging techniques, including AI-assisted analysis, have enhanced diagnostic accuracy. Treatment strategies now emphasize minimally invasive approaches, with endoscopic techniques showing success rates exceeding 90% in experienced centers. Special considerations for specific populations, including elderly patients and those with altered anatomy, have led to refined management algorithms. Future directions include novel stone fragmentation technologies, biodegradable materials, and personalized medicine approaches. The integration of these advances, combined with a multidisciplinary approach, has improved patient outcomes while presenting new opportunities for enhanced care delivery. Continued technological innovation and refined techniques suggest a promising future for CBD stone management, although challenges remain in optimizing treatment selection and preventing recurrence.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11703643 | PMC |
http://dx.doi.org/10.7759/cureus.75246 | DOI Listing |
Gut Liver
September 2025
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Management of common bile duct (CBD) stones has evolved substantially with the advent of endoscopic techniques and dedicated high-end devices. Endoscopic retrograde cholangiopancreatography (ERCP) has become a widespread essential technique for managing CBD stones, with high success rates in standard cases. However, for patients with large stones, stones in an impacted state, and stones in anatomically challenging regions, advanced strategies using various dedicated devices may be needed.
View Article and Find Full Text PDFQuant Imaging Med Surg
September 2025
Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Background: Periampullary diverticulum (PAD) is a common acquired extraluminal outpouching of duodenal mucosa and is often clinically overlooked. When complicated by biliary-pancreatic stones or inflammation, PAD may lead to severe biliary-pancreatic complications. Although endoscopic retrograde cholangiopancreatography (ERCP) is currently regarded as the gold standard for PAD diagnosis, its invasive nature and other limitations have led to computed tomography (CT) being increasingly preferred as the first-line imaging modality.
View Article and Find Full Text PDFJ Clin Med
August 2025
Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu 42472, Republic of Korea.
: Endoscopic retrograde cholangiopancreatography (ERCP) with stone extraction is the standard treatment for common bile duct (CBD) stones. However, when complete removal is not feasible, the temporary placement of a plastic stent (PS) is commonly used. This study aimed to assess 12-month stent patency in elderly patients with CBD stones.
View Article and Find Full Text PDFJ Surg Case Rep
August 2025
Department of Cardiac Surgery, University Hospital Center Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia.
Typical gallstone ileus includes small intestine obstruction caused by the gallstone passing from the gallbladder through the common bile duct (CBD). The case of gallstone ileus with simultaneous obstructive jaundice and intestinal ischemia is an extremely rare scenario. Computed tomography of the abdomen and pelvis is the method of choice for the diagnosis.
View Article and Find Full Text PDFJ Pediatr Surg
August 2025
Division of Pediatric Surgery, Rady Children's Hospital San Diego, La Jolla, CA; Division of Pediatric Surgery, Dept of General Surgery, UCSD School of Medicine, La Jolla, CA. Electronic address:
Background: Guidelines for adult gallstone pancreatitis (GP) in adults recommend endoscopic retrograde cholangiopancreatography (ERCP) for ongoing biliary obstruction. Studies in children are limited by small sample sizes. We sought to explore whether factors predictive of choledocholithiasis (CDL) are correlated with ERCP findings of stones in pediatric GP.
View Article and Find Full Text PDF