Published online Feb 21, 2022. doi: 10.3748/wjg.v28.i7.763
Peer-review started: July 27, 2021
First decision: October 3, 2021
Revised: November 5, 2021
Accepted: January 19, 2022
Article in press: January 19, 2022
Published online: February 21, 2022
Pure endoscopic treatment of combined cholelithiasis and choledocholithiasis is possible due to the chance to use together both endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) approaches. This endotherapy permits to treat biliary stones in the main bile duct by standard ERCP and gallbladder stones by EUS-guided cholecystoduodenostomy eventually associated to intracorporeal lithotripsy to achieve optimal results.
Core Tip: Combining endoscopic approaches of endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) let to treat simultaneously biliary stones both in the gallbladder and in the main bile ducts. ERCP standard approach can be associated to EUS-guided gallbladder drainage to avoid recurrences in patients unfit for surgery. To optimize this treatment, gallbladder stones can be fragmented by intracorporeal lithotripsy so their fragments can easily pass through the stent in place for cholecystoduodenostomy. This mininvasive approach seems promising on the base of available literature.