ENDOSCOPIC TREATMENT OF SYMPTOMATIC CHOLEDOCHOLITHIASIS

BACKGROUND/AIMS: Today, different endoscopic techniques are available to treat choledocholithiasis. These techniques include mechanical lith otripsy (ML), electrohydraulic lithotripsy (EHL), laserlithotripsy (LL ), and extracorporal shock-wave lithotripsy (ESWL). These techniques h ave to compete with laparoscopic stone removal which is performed with increasing fi frequency at some centers. METHODOLGY: We report the re sults; of treatment of choledocholithiasis and compare the results wit h a meta-analysis of studies in whom endoscopic and laparoscopic techn iques were applied. From 1994-1995, 217 patients with symptomatic chol edocholithiasis were treated using endoscopic retrograde cholangiograp hy (ERC). RESULTS; Overall, complete stone removal was successful in 9 8% of all patients and only 5 patients had to undergo surgery. Complet e endoscopic removal of stones was achieved in 70%: during the first E RC session. In 47 patients consecutive ERC sessions with application o f EML, EHL, or ESWL were necessary to completely remove the stones. Co mplication rate was: 5%; and included pancreatitis and bleeding from p apillotomy. There was no procedure-related mortality. CONCLUSION: The study suggests that today ERC: if mains the treatment of choice in mos t patients with symptomatic choledocholithiasis.