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The removal of gallstones is an integral application for Endoscopic Retrograde Cholangiopancreatography (ERCP). When stones become impacted at the papilla or in the common bile duct, this becomes an indication for urgent intervention. Stone extraction is now routinely performed using endoscopy.
Usually, a successful cannulation followed by a sphincterotomy is performed first. After these preparations, stones may be removed by a number of means depending on their size and consistency. In the case of smaller stones or ‘sludge’, a balloon may be inserted along the guidewire until it is beyond the obstruction. When it is inflated and withdrawn, the balloon will pull the stones out of the bile duct. Larger stones may be caught and extracted with a retrieval basket.
Extremely large stones may require crushing to allow them to be extracted (lithotripsy). Mechanical lithotripsy – being the standard among other lithotripsy techniques – is performed using a dedicated lithotriptor basket with stronger wires; when the stones are caught the basket wires are tightened, thus crushing the stones into smaller fragments for removal. When a stone caught in a retrieval basket becomes impacted in the common bile duct, an emergency lithotripsy may need to be performed.
Olympus offers a comprehensive range of stone extraction devices, to extract or crush gallstones of all sizes. The Multi-3V Plus balloon-tip catheters are made of thick, high-quality latex, giving outstanding durability for repeated use. A wide range of retrieval and lithotriptor baskets is available, allowing physicians to capture and safely remove all types of stones. The retrieval baskets come in a conventional four-wire design as well as in a unique eight-wire design for the extraction of small stones.