Endoscopic ultrasound-guided transhepatic antegrade stone removal for choledocholithiasis after pancreaticoduodenectomy: A case report and review of literature

Table 1 Comparative analysis of post-pancreaticoduodenectomy choledocholithiasis management strategies

Method	Success rate	Major limitations	Complication rate	Ref.
ERCP	< 20%	Anatomical inaccessibility, long Roux limbs, adhesions	10%-25% (perforation, pancreatitis)	[17-19]
PTCSL	70%-88%	External drain burden, fistula risk, requires multiple sessions	10%-30% (bleeding, infection)	[20,21]
Surgical revision	> 90%	High morbidity/mortality (5%-15%), challenging reoperation	5%-20% (anastomotic leak, recurrent stricture)	[22,23]
EUS-TASR	85%-95%	Requires advanced expertise, limited right-duct access	8%-15% (bleeding, bile leak)	[24,25]

ERCP: Endoscopic retrograde cholangiopancreatography; PTCSL: Percutaneous transhepatic cholangioscopic lithotripsy; EUS-TASR: Endoscopic ultrasound-guided transhepatic antegrade stone removal.