Clinique Paris-Bercy, Service d’endoscopie interventionnelle, 9 quai de Bercy, 94220 Charenton-le-Pont
Endoscopic treatment has become, according to the latest recommendations, the reference treatment for common bile duct stones (CBDS), although in some situations surgical management at the same time as laparoscopic cholecystectomy is a possible alternative. The purpose of this article is to describe the endoscopic treatment of CBDS, detailing all its possible modalities and their indications. Thus, the different techniques of lithotripsy, the place of biliary drainage (by plastic or metallic stents) are explained as well as sphincteroplasty and especially sphincterotomy with endoscopic papillary large-ballon dilation, a recently described technique that has modified the strategy of endoscopic management of CBDS. This strategy of endoscopic management of CBDS, combining these different techniques, is presented. Then, specific situations such as CBDS in the event of macro-calculations, coagulation disorders, difficulties in endoscopic access to the papilla, or during pregnancy will be addressed.