Olympus EndoTherapy Biliary Stone Removal Procedure

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Overview

It is estimated that approximately one million people in the U.S. are diagnosed with gallstones. Of that number, 10 percent also have stones present in the bile duct.¹

About 75 percent of all gallstones are formed from cholesterol and salts present in the bile. If the liver secretes too much cholesterol, supersaturation can occur and cholesterol may precipitate out of the bile solution to form gallstones. These stones appear yellow in color.

The other 25 percent of gallstones are known as pigment gallstones. They are composed of bilirubin and calcium salts that are also present in bile. These stones are usually black or brown and often form in the gallbladders of people with sickle cell anemia or cirrhosis.

Symptoms of Biliary Stones

Approximately 50 percent of people with gallstones have no symptoms. If the stone moves around in the gallbladder or lodges in the cystic or common bile duct, the patient can experience biliary colic. Biliary colic is pain that can occur in the back, shoulder blades, or right shoulder 3-6 hours after ingesting a heavy meal. Nausea and vomiting can also occur. If the stone is blocking the flow of bile, fever and chills as well as jaundice (yellowing of the skin) can occur.

Treatment

Depending on the size and location of the gallstone in the anatomy, an extraction balloon or retrieval basket can be used to remove the gallstone during an ERCP.

An extraction balloon can be used for common bile duct stones <1 cm in diameter. The balloon is advanced into the bile duct above the stone and then inflated. The balloon and stone are then pulled through the ampulla.

A retrieval basket is designed to accommodate a wide range of stone sizes. Bullet-tipped versions aid in cannulation and are rotatable to simplify stone capture while wireguided baskets aid in retrieval from the intrahepatic ducts.