Comprehensive review on small common bile duct stones

World J Gastroenterol. 2023 Apr 7;29(13):1955-1968. doi: 10.3748/wjg.v29.i13.1955.


Common bile duct stones are among the most common conditions encountered by endoscopists. Therefore, it is well researched; however, some items, such as indications for endoscopic papillary balloon dilatation (EPBD), safety of EPBD and endoscopic sphincterotomy in patients receiving dual antiplatelet therapy or direct oral anticoagulant, selection strategy for retrieval balloons and baskets, lack adequate evidence. Therefore, the guidelines have been updated with new research, while others remain unchanged due to weak evidence. In this review, we comprehensively summarize the standard methods in guidelines and new findings from recent studies on papillary dilation, stone retrieval devices, difficult-to-treat cases, troubleshooting during the procedure, and complicated cases of cholangitis, cholecystolithiasis, or distal biliary stricture.

Keywords: Choledocholithiasis; Choledocholithotomy; Common bile duct stones; Endoscopic papillary balloon dilation; Endoscopic sphincterotomy; Small common bile duct stones.

Publication types

  • Review

MeSH terms

  • Catheterization / methods
  • Cholangiopancreatography, Endoscopic Retrograde / adverse effects
  • Cholangiopancreatography, Endoscopic Retrograde / methods
  • Common Bile Duct
  • Dilatation / methods
  • Gallstones* / complications
  • Gallstones* / surgery
  • Humans
  • Sphincterotomy, Endoscopic / methods
  • Treatment Outcome