Abstract
The choice of treatment for bile duct stones is either by endoscopic approach; endoscopic sphincterotomy (EST) and endoscopic papilla balloon dilation (EPBD), or surgical approach; open and laparoscopic bile duct exploration. The bleeding and perforation in the EST group and pancreatitis in the EPBD group are frequent complications. These complications induce critical conditions, thus careful procedures and follow-up are necessary. The reported recurrent rates of bile duct stones in the EST group tend to be higher than in the EPBD group, however further long-term follow up study after EPBD is mandatory. The number of laparoscopic common bile duct explorations increases, however its advantage should be considered when the incidences of postoperative complications and long-term prognosis after laparoscopic surgery are evaluated. At present, the most preferable treatment procedure can be selected at each institution to decrease the short-term and long-term morbidities. Since the bile duct stone and acute cholangitis are closely related and the initial treatment for moderate/severe cholangitis is endoscopic biliary drainage, both surgical and endoscopic approach should be provided for patients with bile duct stones.
