在美国，超过30%的内镜逆行胆管造影（Endoscopic Retrograde Cholangiography, ERCP）手术与胆管结石取出相关，而在这些病例中，超过10–15%被记录为复杂或困难结石。
本文献的目的是定义困难胆总管结石的特征，并提供一种系统化的治疗方案来处理这些困难病例。综述描述了识别困难胆石的特殊临床情况，并提供了额外的管理策略以辅助内镜下胆石取出。
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