What method provides the best outcome for stone removal for stones in the common hepatic duct proximal to the cystic duct takeoff?

Endobiliary stenting with ERCP (Endoscopic Retrograde Cholangiopancreatography) is the best method for achieving optimal outcomes in the removal of stones located in the common hepatic duct, particularly when they are positioned proximal to the cystic duct takeoff. This technique enables direct access to the bile ducts, allowing for the identification and retrieval of stones via a non-invasive approach.

ERCP is a minimally invasive procedure that utilizes endoscopic techniques combined with fluoroscopic imaging to visualize and treat conditions of the biliary and pancreatic systems. In this context, the use of endobiliary stenting not only facilitates the removal of stones but also alleviates potential complications associated with obstructive jaundice. By placing a stent in the bile duct, the procedure can help manage any resulting biliary obstruction, ensuring bile can flow more freely, thereby reducing the risk of cholangitis or pancreatitis.

Furthermore, ERCP is generally preferred over open surgical methods or laparoscopic removal for this specific indication because it minimizes surgical trauma, shortens recovery times, and reduces hospitalization durations. Open surgical extraction is more invasive and is associated with higher morbidity, particularly in patients who might have comorbid conditions. While laparoscopic methods can be effective for gallbl