What procedure is used both to diagnose and treat choledocholithiasis?

What procedure is used both to diagnose and treat choledocholithiasis?

• A. MRCP
• B. Endoscopic ultrasound
• C. Surgical exploration
• D. ERCP

Answer: (D)

The key idea is a procedure that can both confirm the presence of stones in the common bile duct and remove them in the same session. Endoscopic retrograde cholangiopancreatography accomplishes this: an endoscope is guided to the duodenum, the bile duct is cannulated, and contrast is injected to visualize the biliary tree. If stones are present, this imaging confirms choledocholithiasis. Therapeutically, ERCP allows direct intervention. A sphincterotomy can be performed to widen the opening of the duct, and stones can be retrieved with baskets or nets or even fragmented with lithotripsy, with stents placed if necessary to relieve obstruction. Because ERCP combines both diagnosis and treatment, it’s the preferred approach for choledocholithiasis when intervention is anticipated. Other options are mainly diagnostic or staged approaches. MRCP visualizes the biliary tree noninvasively but does not treat, while endoscopic ultrasound is highly sensitive for detecting stones but does not by itself extract them. Surgical exploration is invasive and not typically used for initial diagnosis and treatment of this condition.

The key idea is a procedure that can both confirm the presence of stones in the common bile duct and remove them in the same session. Endoscopic retrograde cholangiopancreatography accomplishes this: an endoscope is guided to the duodenum, the bile duct is cannulated, and contrast is injected to visualize the biliary tree. If stones are present, this imaging confirms choledocholithiasis.

Therapeutically, ERCP allows direct intervention. A sphincterotomy can be performed to widen the opening of the duct, and stones can be retrieved with baskets or nets or even fragmented with lithotripsy, with stents placed if necessary to relieve obstruction. Because ERCP combines both diagnosis and treatment, it’s the preferred approach for choledocholithiasis when intervention is anticipated.

Other options are mainly diagnostic or staged approaches. MRCP visualizes the biliary tree noninvasively but does not treat, while endoscopic ultrasound is highly sensitive for detecting stones but does not by itself extract them. Surgical exploration is invasive and not typically used for initial diagnosis and treatment of this condition.