What should be done if bile duct stones cannot be removed by ERCP?

When bile duct stones cannot be removed via ERCP, medical treatment, hepatic resection surgery, or T-tube placement are usually required.

1. Medical Treatment

ERCP stone removal is primarily a procedure targeting stones in the common bile duct and some stones in the hilar region, serving as a minimally invasive method for treating biliary tract stones. However, because of the distant location of certain liver areas, it may not be possible to remove stones using ERCP. In such cases, medications such as roxithromycin dispersible tablets, azithromycin dispersible tablets, and cefoxitin sodium tablets can be taken under a doctor's guidance.

2. Hepatic Resection Surgery

If medical treatment fails, hepatic resection surgery is generally needed to remove stones from the liver and bile ducts. Additionally, if stones are located in distal regions or there are multiple stones that cannot be completely cleared, hepatic resection surgery is often considered to thoroughly remove all stones.

3. T-Tube Placement

If stones cannot be accessed and liver resection is not feasible, a T-tube may be placed. Further stone removal can then be performed through the T-tube, primarily to prevent intrahepatic stones from causing obstruction of the common bile duct.

If stones within the bile ducts cannot be removed, various treatment options are available, so there is no need for excessive concern. In daily life, it is important to rest adequately, avoid overexertion, and maintain a balance between work and rest.