Korean J Pancreas Biliary Tract.
2024 Oct;29(4):128-134. 10.15279/kpba.2024.29.4.128.
Revised Clinical Practice Guideline of Korean Pancreatobiliary Association for Common Bile Duct Stones: Endoscopic Management of Common Bile Duct Stones
- Affiliations
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- 1Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- 2Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
- 3Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- 4Department of Internal Medicine, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
- KMID: 2560376
- DOI: http://doi.org/10.15279/kpba.2024.29.4.128
Abstract
- For the optimal treatment of common bile duct (CBD) stones, several facts should be considered before or during endoscopic retrograde cholangiopancreatography (ERCP). Prophylactic antibiotics is necessary for the patients with high risk of post ERCP cholangitis and cessation of anticoagulant should be considered for prevention of complications associated with post ERCP bleeding. Furthermore, endoscopic papillary balloon dilatation can be replaced with endoscopic sphincterotomy in patients with bleeding tendency such as chronic kidney disease, liver cirrhosis, thrombocytopenia etc. Prophylactic pancreatic duct stent can be helpful in reducing post ERCP pancreatitis (PEP) but caution is required as excessive attempts for selective cannulation into pancreatic duct for stent insertion can cause PEP. If gallbladder stone is present and treatment for CBD stones has been completed, prophylactic cholecystectomy should be performed selectively after consideration of patient’s condition.
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