Johns Hopkins Manual for GI Endoscopic Nurses, Third Edition

Mouen Khashab, MD; Toshunia Robinson, MD; Anthony Kalloo, MD

Chapter 38: Ercp With Stone Removal (continued)

Vikesh K. Singh, MD, MSc

The removal of stone(s) from the bile and pancreatic ducts can be accomplished using a variety of accessories alone or in combination. The endoscopist may choose to use a stone retrieval balloon, a wire basket, and/or a mechanical lithotripter. The removal of the majority of bile duct stones can be easily accomplished using a stone retrieval balloon. After the stone(s) is identified on cholangiogram, a biliary sphincterotomy is performed and a stone retrieval balloon is advanced to just above the level of the stone. The balloon (available in 8.5, 11.5, and 15 mm) is inflated to approximate…