The technique of endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (ES), for removal of bile duct (BD) stones have been highly successful (>90%). The preoperative indications include cholangitis, worsening gallstone pancreatitis, patients with jaundice, and in those patients who have common bile duct stones seen on ultrasonography.
Intraoperatively ERCP/ES has been used along with the placement of a papillotome through the cystic duct and papilla and performing a sphincterotomy in an antegrade fashion. The approach with the least complications is with the antegrade passage of the papillotome, and both techniques are efficient and safe in removal of proximal and distal BD stones.
The postoperative indications for ERCP include retained common bile duct stones, bile duct injury, bile leak, and in patients who have developed a bile duct stricture. A success rate of 90% to 95% for complete removal of bile duct stones has been achieved.
Overall, ERCP/ES is a highly effective procedure for removing bile duct stones, but it should be used only in selected patients preoperatively, intraoperatively, and postoperatively.
McCune WS , Shorb PE, Moscovitz H.: Endoscopic cannulation of the ampulla of Vater. Ann Surg167:752-755, 1968
2.
Oi I., Takeomoto T., Kondo T.: Fiberduodenoscope direct observations of the papilla of Vater. Endoscopy1:101-103, 1969
3.
Classen M., Demling L.: Endoskopische sphincterotomie der papilla vateri and steinextraktion aus ductus choledochus. Dtsh Med Wochensche99:496-497, 1974
4.
Cotton PB: Endoscopic management of bile duct stones (apples and oranges). Gut25:587-597, 1984
5.
Vaira D., Ainley C., Williams S., et al: Endoscopic sphincterotomy in 1,000 consecutive patients. Lancet2:431-433, 1989
6.
Lambert ME, Betts CD, Faragher EB, et al: Endoscopic sphincterotomy: The whole truth. Br J Surg78:473-476, 1991
7.
Cotton PB, Lehman G., Vennes, et al: Endoscopic sphincterotomy, complications and their management. An attempt at consensus . Gastrointest Endosc37:383-393, 1991
8.
Cotton PB: Endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy . Am J Surg165:474-478, 1993
9.
.9. Noack KB, Speer AG: Endoscopic management of stones, in Toouli J, Gossot D, Hunter JG (eds): Endosurgery. New York, NY, Churchill Livingstone, 1996, pp 525-543
10.
Neuhaus H., Feussner H., Ungeheuer A., et al: Prospective evaluation of the use of endoscopic retrograde cholangiography prior to laparoscopic cholecystectomy. Endoscopy24:745-749, 1992
11.
Stiegmann GV , Gough JS, Mansour A., et al: Precholectystectomy endoscopic cholangiography and stone removal is not superior to cholecystectomy, cholangiography and common bile duct exploration. Am J Surg163:227-230, 1992
12.
Heinerman PM , Boeckl O., Pimpl W.: Selective ERCP and preoperative stone removal in the bile duct surgery. Ann Surg209:267-272, 1989
13.
Stain SC, Cohen H., Tsuishoysha M., et al: Choledocholithiasis. Endoscopic sphincterotomy or common bile duct exploration. Ann Surg213:627-634, 1991
14.
Ellul Jpm , Wilkinson ML, McColl I., et al: A predictive ERCP study of patients with gallbladder stones and probable choledocholithiasis-predictive factors . Gastrointest Endosc38:226, 1992, (abstr)
15.
Graham SM, Flowers JL, Scott TR, et al: Laparoscopic cholecystectomy and common bile duct stones. Ann Surg218:61-67, 1993
16.
Hauser-Jansen M., Karesen R., Nygaard K., et al: Prospective randomized study of routine intraoperative cholangiography during open cholecystectomy: Long term follow up and multi-variate analysis of predictors of choledocholithiasis . Surgery113:318-323, 1993
17.
O'Rouke NA, Askew AR, Cowen AE, et al: The role of ERCP and endoscopic sphincterotomy in the era of laparoscopic cholecystectomy . Aust N ZJ Surg63:3-7, 1993
18.
Surick B., Washington M., Ghazi A.: Endosscopic retrograde cholangiopancreatography in conjunction with laparoscopic cholecystectomy. Surg Endosc7:388-392, 1993
19.
Vanneman W, Kingsbury R., Duberman E., et al: When is ERCP indicated before laparoscopic cholecystectomy? Gastrointes Endosc38: 265, 1992, (abstr)
20.
Hunter JG: Laparoscopic transcystic common bile duct exploration. Am J Surg163:53-58, 1992
21.
Curly PJ, Martin I., McMahon MJ: The impact of minimally invasive techniques upon exploration of the common bile duct. Presented at the Annual Scientific Meeting of the Association of Surgeons of Great Britain and Ireland, 1992
22.
Mitchell SA , Jacyna MR, Chadwick S.: Common bile duct stones: A controversy revisited . Br J Surg80:759-769, 1993
23.
Santucci L. , Natalini G., Sarpi L., et al: Selected endoscopic retrograde cholangiography and preoperative bile duct stone removal in patients scheduled for laparoscopic cholecystectomy: A prospective study. Am J Gastroenterol91:1326-1330, 1996
24.
Kum CK, Goh Pmy: Preoperative ERCP in the management of common bile duct stones before laparoscopic cholecystectomy. EurJ Surg162:205-210, 1996
25.
Acosta JM, Ledesma CL: Gallstone migration as a cause of acute pancreatitis. N Engl J Med290:484, 1974
26.
Kelly TR: Gallstone pancratitis: Pathophysiology. Surgery80:488, 1976
27.
Chang L., De Virgilio C., Lo Sk, et al: A prospective, randomized trial assessing the timing and cost of ERCP in gallstone pancreatitis. Am J Gastroenterol90:189, 1995
28.
DeVirgilio C., Verbin C., Chang L., et al: Gallstone pancreatitis. The role of preoperative endoscopic retrograde cholangiopancreatography. Arch Surg129:909-912, 1994
29.
Kelly TR, Wagner DS: Gallstone pancreatitis: A prospective randomized trial of the timing of surgery . Surgery104:600-605, 1988
30.
Neoptolemos JP, Carr-Locke DL, London NJ, et al: Controlled trial of urgent endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy versus conservative treatment for acute pancreatitis caused by gallstones . Lancet2:979-983, 1988
31.
Fan ST, Lai Ecs, Mok Fpt, et al: Early treatment of acute biliary pancreatitis by endoscopic papillotomy. N Engl J Med80:247-250, 1993
32.
Leung JWC,Ling Tkw, Chan Rcy, et al: Antibiotics, biliary sepsis, and bile duct stones. Gastrointest Endosc40:716-721 , 1994
33.
Lai Ecs , Tam PC, Paterson IA, et al: Emergency surgery for severe acute cholangitis: The high risk patients. Ann Surg211:55-59, 1990
34.
Lai Ecs , Mok Fpt, Tan Esy, et al: Endoscopic biliary drainage for severe acute cholangitis. N Engl J Med326:1582, 1994
35.
DePaula AL, Hashiba K., Bafutto M., et al: Laparoscopic antegrade sphincterotomy. Surg Laparosc Endosc3:157-160, 1993
36.
DePaula AL, Hashiba K., Bafutto M., et al: Laparoscopic antegrade sphincterotomy. Seminars in Laparoscopic Surgery, 4:42-44, 1997
37.
Davids P., Tanka A., Rauws E., et al: Benigh biliary strictures: Surgery or endoscopy? Ann Surg217:237-243, 1993
38.
Geenen D., Geenen J., Hogam W., et al: Endoscopic therapy for benign bile duct strictures. Gastrointest Endosc35:367-371, 1989
39.
Huibregtse K., Katon R., Tytgat G.: Endoscopic treatment of postoperative biliary strictures. Endoscopy18:133-137, 1986
40.
Berkelhammer C., Kortan P., Haber G.: Endoscopic biliary prostheses as treatment for benign postoperative bile duct strictures. Gastrotest Endosc35:95-101, 1989
