The Korean Journal of Gastroenterology :eISSN 2233-6869 / pISSN 1598-9992


Table. 1.

Etiologies of Difficult Biliary Stone Extraction (Modified from Podboy et al.12)

Stone characteristics Papillary access issues Bile duct characteristics Stone location
Large stones >1.5 cm Surgically altered anatomy Sigmoid ductal shape Intrahepatic stones
Numerous stones Luminal narrowing (intrinsic or extrinsic) Short ductal length Cystic duct stones
Barrel-shaped stones Duodenal/biliary diverticula Hyper-acute biliary ductal angulation Impacted ampullary stones
Stones with unusual hardness Papillary stenosis Downstream biliary stricture Mirizzi syndrome
Redundant papillary tissue Bile duct diverticulum
Recessed or obscured papilla
Korean J Gastroenterol 2022;79:199~202
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