ERCP in the diagnosis and treatment of biliary stones: adherence to traditional approaches and innovation
10.3760/cma.j.cn113884-20250220-00054
- VernacularTitle:ERCP在胆管结石诊治中的守正与创新
- Author:
Zhendong JIN
1
Author Information
1. 海军军医大学第一附属医院消化内科 国家消化系统疾病临床医学研究中心 海军军医大学免疫与炎症全国重点实验室，上海 200433
- Publication Type:Journal Article
- Keywords:
Gallstones;
Endoscopic retrograde cholangiopancreatography;
Radiation-free
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(6):401-405
- CountryChina
- Language:Chinese
-
Abstract:
The incidence of bile duct stones, as a prevalent disorder of digestive system, has been increasing annually. Challenges such as high recurrence rates, management of complex cases, and applicability in specific populations remain in clinical practice. Endoscopic retrograde cholangiopancreatography (ERCP), renowned for its precise localization and efficient stone removal, has long been regarded as the first-line treatment for choledocholithiasis. However, the limitations of traditional X-ray-guided ERCP have spurred ongoing innovations in its technology, which is an art of balance between " preserving tradition" and " embracing innovation". This work systematically reviewed the evolution and breakthroughs of ERCP and its derivative techniques in the diagnosis and treatment of bile duct stones, with a focus on advances in the radiation-free ERCP and cholangioscopy-guided lithotripsy. Additionally, it addresses diagnostic methods for bile duct stones complicated by strictures, ERCP strategies for concurrent bile duct and gallbladder stones, and novel approaches to preserving the duodenal papilla. Nevertheless, the adoption of these innovations remains constrained for procedural complexity, equipment costs, and expertise of operator. Future efforts should emphasize the multidisciplinary collaboration, technical standardization, and optimization of devices to greater precision and less invasiveness in ERCP, making it more applicable to diverse clinical scenarios, and ultimately achieving comprehensive progress in personalized management of bile duct stones.
