During ERCP, after catheterization of the biliary tract and infusion of contrast, an X-ray is performed, which can show stones that may be obstructing the bile flow and causing symptoms in the patient.
After this diagnosis, an endoscopic sphincterotomy is performed to widen the exit of the bile duct. This allows for the removal of stones from the biliary tract and enables the normal return of bile drainage from the liver to the duodenum.
Usually, simply opening the exit of the bile duct is not enough for the stone to pass. In these cases, we need to insert instruments through the duodenoscope such as baskets or balloons to sweep the biliary tract from top to bottom and thus extract the stones.
When the stone is very large, we need to break it up to remove it, this procedure is called mechanical lithotripsy. This is performed by capturing the stone with a basket, which is then closed until the stone breaks.
Occasionally, if the stone does not break or is too large, a stent can be placed through the opening to drain the biliary tract and relieve the obstruction. Generally, the examination is repeated a few days later for another attempt at stone removal by endoscopy. If attempts by endoscopy fail, the patient is subjected to surgery to definitively resolve the problem.
Residência em Endoscopia Digestiva no Hospital das Clínicas da USP (HCFMUSP)
Residência em Gastroenterologia no Hospital Universitário da UFSC
Presidente da SOBED / SC na gestão 2018-2020
Médico da clínica Endogastro em Florianópolis e ProGastro em Joinville