الفهرس 
INTRODUCTION AND AIM OF THE WORKOnly 14 pages are availabe for public view
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Abstract
Aim of the work
This essay represents different options regarding biliary lithiasis namely: etiology, diagnosis and different therapeutic trends especially the most recent aiming at approaching a conclusive idea about biliary lithiasis.
This essay aims at representing a comprehensive study of different trends of management of biliary lithaisis in a comparative view.
Conclusion
Trials of extraction of stones endoscopically must be done during the ERCP procedure through sphincterotomy alone with Dormia bascket. Thus the procedure of choice for clearing common bile duct stones. If it failed or there was a contraindications for endoscopic removal. Like big impacted stone larger than 20mm or the presence of other pathology which require another surgical interference, the surgical removal was indicated with or without additional drainage procedure like choledochoduodenostomy or sphicteroplasty. If T-tube was present, flushing with saline and heparin should be tried, if failed, endoscopic removal was recommended, then the reoperation as last step. This is a safe and easy protocol for the management of stones in common bile duct.
Medical dissolution and lithotripsy are still used options of treatment in some centers and still needs further development to improve the results and decrease the incidence of side effects and reduce the recurrent rate.