内镜逆行胰胆管造影治疗胆总管小结石的造影技术研究进展OA

Endoscopic retrograde cholangiopancreatography(ERCP)is the first-line treatment for simple common bile duct stones,with high success rates,minimal trauma,and rapid recovery.During an ERCP procedure,cholangiography is an extremely important step,as it can show the location,size,number of stones,and the condition of the biliary tree,thereby determining the difficulty of stone removal,the method of stone removal,and the final stone clearance rate.Some small stones in the common bile duct(diameter≤5 mm)may pass spontaneously without stone extraction.In contrast,symptomatic small stones in the common bile duct still require ERCP for stone removal.However,some of them can be difficult to visualize during cholangiography,and they may even enter specialized locations such as the intrahepatic bile ducts or the cystic duct,making them impossible to locate or even leading to failure in stone removal.Furthermore,the possibility of spontaneous expulsion of small common bile duct stones from symptom onset to ERCP procedure performed,making it more challenging to determine whether stones have been expelled or remain non-visualized when contrast imaging is negative.Therefore,using different cholangiographic methods to improve stone visibility during ERCP for small bile duct stones is an important measure to increase stone clearance rates.Currently,there is still a lack of recognized evidence-based medical evidence for this issue.This article reviews the current research status of cholangiography methods in ERCP for small stones in the common bile duct.