Endoscopic management of biliary tract stones and stenosis.

The role of endoscopy in managing biliary tract stones and stenosis is surveyed. Rapid advances in endoscopic videoimaging with small diameter maneuverable or large instrument channel endoscopes allows diagnosis and therapy under visual or radiographic control at almost any site in the biliary tree. Techniques for cytology, biopsy, sphincterotomy, mechanical or laser lithotripsy, dilatation with balloon or bougie, large (15 F) or small stent insertion, "polypectomy" or excision with laser or electrosurgery, and brachytherapy provide a therapeutic armamentarium that must be considered as painless, low risk, and cost-effective alternatives to surgical or percutaneous therapy.