The management of bile duct stone disease is the most common indication for endoscopic retrograde cholangio-pancreatography (ERCP). The majority of cases may be resolved using standard approaches including endoscopic sphincterotomy and balloon stone extraction. Recent advances in the management of large or challenging stones has come from the clear evidence for the role of endoscopic papillary large balloon dilatation (EPLBD)/sphincteroplasty and the development of cholangioscopically directed lithotripsy. Perhaps the greatest improvement in endoscopic stone management will be achieved through the implementation of plans for more formalised training, reflection and audit of ERCP performance indicators and network-wide coordination of ERCP services.
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Please note this is for the Frontline Gastroenterology issue that corresponds with Endolive UK.
Contributors The article was written by PW and GJMW in collaboration. GJMW has acted on Advisory Boards for Cook Medical and Boston Scientific Inc.
Competing interests None declared.
Provenance and peer review Commissioned; externally peer reviewed.
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