Abstract
BackgroundThis study aims to evaluate the efficacy and safety of detecting and removing residual common bile duct stones (CBDS) using direct peroralcholangioscopy (DPOC) after performing endoscopic retrograde cholangiopancreatography (ERCP) for stone retrieval.MethodsFrom January 5, 2017 to December 27, 2017, a total of 164 cases of choledocholithiasis were treated by ERCP for stone retrieval. According to the inclusion and exclusion criteria, the remaining 79 cases (39 males; mean age: 63.3 years old, range: 52–79 years old) were enrolled in the present study. The maximum transverse stone diameter was 6–15 mm (12.7 ± 4.2 mm), as determined by ERCP. Furthermore, there were 57 cases of multiple stones (number of stones: two in 41 cases, three in nine cases, and ≥ 4 in seven cases), 13 cases of post-mechanical lithotripsy, and nine cases of broken stones.ResultsThe overall success rate of DPOC was 94.9% (75/79). Furthermore, 18.7%(14/75) of cases were directly inserted, 72%(54/75) of cases required guide wire assistance, and 9.3%(7/75) of cases were successfully inserted with overtube assistance. The average insertion time was 7–17 min (4.9 ± 2.9 min). Residual stones were detected in 19 cases (25.3%), and all of which were < 5 mm in diameter. Moreover, five cases of formed stones were removed by basket and balloon catheter, while the remaining cases were cleaned after irrigation and suction. There were no serious complications.ConclusionDPOC is safe and effective for both the detection and removal of residual CBDS after conventional ERCP.
Highlights
This study aims to evaluate the efficacy and safety of detecting and removing residual common bile duct stones (CBDS) using direct peroralcholangioscopy (DPOC) after performing endoscopic retrograde cholangiopancreatography (ERCP) for stone retrieval
Small stones may be overlooked due to concealment by contrast agents [2], which may increase the risk of recurrence of stones in the future [3]. These residual bile duct stones can be identified by intraductal ultrasonography (IDUS) and choledochoscopy, but several disadvantages limit the application of this approach [4]
Patients From January 5, 2017 to December 27, 2017, a total of 164 cases of choledocholithiasis were treated by endoscopic retrograde cholangiopancreatography (ERCP) for stone retrieval
Summary
This study aims to evaluate the efficacy and safety of detecting and removing residual common bile duct stones (CBDS) using direct peroralcholangioscopy (DPOC) after performing endoscopic retrograde cholangiopancreatography (ERCP) for stone retrieval. Cholangiography is generally performed to confirm bile duct clearance after stone retrieval. Small stones may be overlooked due to concealment by contrast agents [2], which may increase the risk of recurrence of stones in the future [3]. These residual bile duct stones can be identified by intraductal ultrasonography (IDUS) and choledochoscopy, but several disadvantages limit the application of this approach [4].
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have