Factors Significantly Contributing to a Failed Conventional Endoscopic Stone Clearance in Patients with “Difficult” Choledecholithiasis: A Single-Center Experience

Table 1

Selected criteria potentially contributing to the difficulty of endoscopic SE.

Anatomic variations/alterations	Stone factors	Duct factors	Patients factors
Periampullary diverticula^a	15 mm in diameter	Acute distal CBD angulation^b	Age 85 years
Postgastrectomy Billroth type II or Roux-en-Y reconstruction	4 in number (multiple stones)
Presence of T-tube in situ + proximal lithiasis	Impacted stones
Iatrogenic injury to the extrahepatic biliary tree + lithiasis	Intrahepatic or cystic duct stones

Defined endoscopically as a depressed lesion of 5 mm or more with intact mucosa and with the major papilla either within it or close by [17].
^bDefined as the sharpest angle along the CBD from 1 cm below the bifurcation to 1 cm above the papilla [15].