Treatment strategies and skills for incarcerated choledocholithiasis in distal common bile duct        LIU Jin-gang. Department of General Surgery，Shengjing Hospital，China Medical University，Shenyang 110004，China
Abstract    The treatment of the incarcerated choledocholithiasis in distal common bile duct is relatively more difficult to deal with for its anatomic particularities. The precise preoperative diagnosis and evaluation must be the determinant of the therapy method. With regard to incarcerated choledocholithiasis in distal common bile duct complicated with acute obstructive suppurative cholangitis，according to the controlled theory it should put the focus of treatment on the problem that the drainage of the bile duct for alleviation of biliary obstruction is superior to the management of the stones. Nowadays the therapy methods include the combination of LC and EST，or LCBDE assisted by choledochoscopic crushing technique and so on. The latter method should be advocated. Meanwhile, choledocho-pancreatico-duodenal junction injuries should be avoided and application of Oddi’s sphincteroplasty should be reduced as far as possible.