PAEA Surgery End Of Rotation (EOR) Practice Exam

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What endoscopic procedure is used to extract stones in cases of choledocholithiasis?

ERCP - Endoscopic retrograde cholangiopancreatography
EGD - Esophagogastroduodenoscopy
Colonoscopy
Angioplasty

The correct answer is: ERCP - Endoscopic retrograde cholangiopancreatography

Endoscopic retrograde cholangiopancreatography (ERCP) is indeed the endoscopic procedure used to extract stones in cases of choledocholithiasis. This procedure is specifically designed to access the bile and pancreatic ducts, allowing for both diagnostic imaging and therapeutic interventions. During ERCP, a flexible endoscope is passed through the mouth and into the duodenum, where contrast dye is injected into the bile ducts. This enables visualization of any obstructions, like stones. If stones are identified in the common bile duct, tools can be passed through the endoscope to perform balloon sweep or sphincterotomy, facilitating the extraction of stones. The other procedures listed do not address the condition of choledocholithiasis directly. For example, esophagogastroduodenoscopy (EGD) primarily examines the upper gastrointestinal tract and does not access the bile ducts. Colonoscopy is focused on the colon and rectum, completely bypassing biliary structures. Angioplasty specifically pertains to widening narrowed or obstructed blood vessels and is unrelated to the management of gallstones. Therefore, ERCP remains the standard of care for managing choledocholithiasis by providing both diagnostic and therapeutic capabilities.