Biliary Stone Removal
Biliary Stone Removal - Related Videos
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Biliary System Resin Casting: A Technique for Analyzing 3D Architecture of Biliary System in Murine Model Using Radiopaque Resin Injection
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This video describes the procedure for biliary system resin casting, for understanding 3D biliary architecture. This technique provides insights into the internal diameter and network connectivity of the biliary system, which could be used for liver regeneration analysis.
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The integrated technique described in this protocol achieves real-time biliary mapping via indocyanine green (ICG) fluorescence, minimally invasive stone clearance under direct visualization, and secure primary duct repair (6-0 PDS), eliminating T-tube drainage.
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Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
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Endoscopic Ultrasound-Guided Biliary Drainage (EUS-BD) is an alternative method of biliary decompression in malignant biliary obstruction. Here we describe the technique of EUS guided-Hepaticogastrostomy (EUS-HGS) in a case of unresectable malignant hilar biliary obstruction.
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Quarrying of Stone
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2024
Quarrying is the process of extracting stone from a quarry, where specialized techniques are employed to remove large blocks of stone safely and efficiently. This process can involve controlled explosions or more precision-oriented methods such as cutting and drilling. One common method involves using a diamond belt saw to cut large blocks from the quarry face. These blocks can be about 50 feet long and 12 feet high. After the initial vertical cut, drilling is performed at the base of the block.
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Stone Masonry
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Stone masonry is a construction technique that uses individual stones to build structures and can be categorized into two main types: rubble and ashlar. Rubble masonry uses uneven, naturally shaped stones such as river rocks or fragments from quarries. This method often requires the mason to select and possibly shape each stone to fit the designated space, ensuring a proper build, even with irregular stone sizes and shapes. Ashlar masonry, on the other hand, employs uniformly cut stones that...
FAQs
During ERCP, clinicians access the biliary tree and enlarge the duct opening when necessary. A balloon or basket can then capture and remove a stone after access is established. This sequence combines targeted entry with mechanical extraction, helping restore bile flow while limiting treatment to the obstructed duct.
Larger stones may not be removable through a single straightforward extraction. In those situations, clinicians may fragment the stone before removal or plan staged treatment rather than rely on one attempt. This approach addresses stone size as a technical factor and can support progressive clearance of the biliary tree.
Imaging helps clinicians identify where stones are located and characterize the biliary problem before treatment. For ductal stones, that information supports planning endoscopic access and determining whether duct opening enlargement, balloon extraction, basket use, fragmentation, or staged treatment may be needed. It also informs later decisions about gallbladder management.
A typical endoscopic approach first establishes access to the biliary tree, then enlarges the duct opening if needed, and finally uses a balloon or basket to extract the stone. When direct extraction is not sufficient, fragmentation or staged treatment may be incorporated. The procedure is therefore adapted to the technical demands of the obstruction.
Removing a ductal stone can rapidly relieve jaundice and biliary pain while addressing the obstruction that can contribute to infection or inflammation. These outcomes explain why the intervention is clinically important beyond simply retrieving a stone. Restored flow provides an immediate treatment benefit, while complication prevention remains a central goal.
After a ductal stone is removed, clinicians may still need to decide how to manage the gallbladder. Extraction addresses the immediate ductal obstruction, whereas subsequent gallbladder management is a separate clinical decision informed by the broader biliary situation. This distinction explains why successful ERCP may guide, rather than conclude, the overall treatment plan.