Endoscopic treatment methods for papillary stenosis

ntroduction. According to statistical data, from among all benign cholelithiasis-associated changes in the bile ducts, up to 25% are attributed to stenosis of the major duodenal papilla. It is important to note that papillary stenosis often (in 75–80% of cases) precedes choledocholithiasis. Aim. To review domestic and foreign literature on methods of diagnosis and treatment of papillary stenosis; to analyze instrumental endoscopic methods available in practice, to evaluate the effectiveness of using them, and to identify the advantages and disadvantages of various endoscopic methods for the treatment of papillary stenosis. Materials and Methods. The review includes data from domestic and foreign studies published in electronic bibliographic databases, such as Pubmed, Web of Science, and Google Scholar, over the past 38 years. An analysis was conducted of publications containing information on various treatment methods for papillary stenosis. Results and Discussion. Nine core methods of endoscopic treatment for papillary stenosis were analyzed: Endoscopic papillosphincterotomy, laparoscopic laser papillosphincterotomy, radial papillosphincterotomy, fistulotomy with a needle knife, stenting, antegrade choledochoscopy with papillosphincterotomy combined with laparoscopic cholecystectomy, antegrade endoscopic choledochoscopy with bougienage, endoscopic partial papillosphincterotomy with balloon dilation, and pancreatic duct stenting using the rendezvous technique from the minor papilla to the major papilla. This paper provides a brief description and technique for each method, as well as their advantages and disadvantages. Conclusions. It has been found that the most relevant and efficient technique is antegrade endoscopic choledochoscopy with bougienage.