2-year Study Research Articles

Analysing Nurse Talent Management: A 6-Year Study Before and During COVID-19 Using the McKinsey 9-Box Matrix

Purpose – Talent management plays a pivotal role in shaping the quality and efficacy of health care organizations, with particular significance in nursing. Aims(s) – This research delves into the assessment of talent management for nurses, using the McKinsey 9-Box Matrix, both pre- and post COVID-19 pandemic. Design/methodology/approach – Employing a retrospective design spanning six years, this study encompasses 1319 nurses evaluated using the McKinsey 9-Box Matrix. This method involves performance and potential evaluations, incorporating face-to-face interviews with the Directorate of Nursing Services executive team. Findings – Significant variations in nurse positions, department distributions, and educational backgrounds were observed before and during the COVID-19 pandemic. Noteworthy shifts in McKinsey 9-Box Matrix assessments indicated pandemic-induced changes in nurse categorization. Approximately one-third of nurses were classified as B2: Core Working Group, which is crucial for workforce stability. Gender did not yield significant differences in the McKinsey 9-Box Matrix evaluations. Although variations were noted in categories A1, A2, and B1 before and during COVID-19, employment status did not significantly impact these assessments. Limitations of the study – Findings aweredrawn from a private health care group, potentially limiting generalizability to diverse settings, populations, or contexts. Practical implications – This study provides invaluable insights into the evolving land-scape of nursing during the pandemic. It illuminates shifts in education levels, posi-tions, departments, leadership potential, and specific evaluation categories among nurses. Originality/value – Contributing significantly to the existing literature, this study provides a nuanced analysis of talent management practices among nurses. The in-sights garnered offer a fresh perspective, informing health care organizations’ ‘talent management strategies, especially considering the evolving health care landscape shaped by the pandemic.

Annual incidence and prevalence of injuries in elite male academy cricketers: A 4-year prospective cohort study

ObjectivesThe aim of this study was to describe the epidemiology of injuries; time-loss and non-time loss, in elite male academy cricket. DesignProspective cohort analysis. MethodsAnnual injury incidence and prevalence from all cricket related injuries were calculated for 348 male academy players (under-13 to under-18) from the 18 First-Class County Cricket clubs in England and Wales across four years (2017/18, 2018/19, 2020/21 and 2021/22), in accordance with the updated consensus statement for injury surveillance methods in cricket. ResultsThe average annual injury incidence was 115.0 injuries/100 players/year, with similar rates between time-loss (59.7 injuries/100 players/year) and non-time loss injury incidence (55.3 injuries/100 players/year). On average, 8.5 ​% of players were unavailable on any given day of the year due to injury. Match injury incidence (48.8 injuries/100 players/year) was higher than cricket-based training (25.2 injuries/100 players/year), gym-based training, illness, and ‘other’ injury incidences. Match bowling was the activity associated with the highest total (17.7 injuries/100 players/year), time-loss (10.3 injuries/100 players/year) and non-time loss (7.4 injuries/100 players/year) injury incidence. The lumbar spine was the body location most frequently injured (15.3 injuries/100 players/year) and was the most prevalent body location injured (2.9 ​% of players). ConclusionsThe findings from this study provide, robust evidence of the extent of the injury problem in elite male academy cricketers. Bowling poses the greatest risk to players and the lumbar spine is the most common and prevalent injury location.

Cranial Nerve Injuries After Carotid Endarterectomy: A 15-Year Prospective Study With Routine Otolaryngologist and Neurological Evaluation

Cranial Nerve Injuries After Carotid Endarterectomy: A 15-Year Prospective Study With Routine Otolaryngologist and Neurological Evaluation

Chinese Medicine Prolongs Overall Survival of Chinese Patients with Advanced Gastric Cancer: Treatment Pattern and Survival Analysis of a 20-Year Real-World Study.

To describe the treatment patterns and survival status of advanced gastric cancer (AGC) in China in the past two decades, and objectively evaluate the impact of standardized Chinese medicine (CM) treatment on the survival of AGC patients. This multicenter registry designed and propensity score analysis study described the diagnosis characteristics, treatment-pattern development and survival status of AGC from 10 hospitals in China between January 1, 2000 and July 31, 2021. Overall survival (OS) was evaluated between non-CM cohort (standard medical treatment) and CM cohort (integrated standard CM treatment ≥3 months). Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were performed to adjust any difference in average outcomes for bias. A total of 2,001 patients histologically confirmed locally advanced and/or metastasis stomach and gastroesophageal junction adenocarcinoma were enrolled. Among them, 1,607 received systemic chemotherapy, 215 (10.74%) accepted molecular targeted therapy, 44 (2.2%) received checkpoint inhibitor therapy, and 769 (38.43%) received CM. Two-drug regimen was the main choice for first-line treatment, with fluoropyrimidine plus platinum as the most common regimen (530 cases, 60.09%). While 45.71% (16 cases) of patients with HER2 amplification received trastuzumab in first-line. The application of apatinib increased (33.33%) in third-line. The application of checkpoint inhibitors has increased since 2020. COX analysis showed that Lauren mixed type (P=0.017), cycles of first-line treatment >6 (P=0.000), CM (P=0.000), palliative gastrectomy (P=0.000), trastuzumab (P=0.011), and apatinib (P=0.008) were independent prognostic factors for the OS of AGC. After PSM and IPTW, the median OS of CM cohort and non-CM cohort was 18.17 and 12.45 months, respectively (P<0.001). In real-world practice for AGC in China, therapy choices consisted with guidelines. Two-drug regimen was the main first-line choice. Standardized CM treatment was an independent prognostic factor and could prolong the OS of Chinese patients with AGC. (Registration No. NCT02781285).

Frequency of apical periodontitis in root-filled teeth restored with post and core: A 5-year retrospective study.

In conjunction with post placement in root-filled teeth with periapical healthy conditions, root canal retreatment may be performed to improve the seal of the root canal. Whether root canal retreatment for technical reasons (retreatments in teeth without apical periodontitis (AP)) results in lower frequency of AP is unknown. To examine whether there is a difference in frequency of AP between roots with root canals retreated for technical reasons, and roots with root canals not retreated before post placement, with a minimum follow-up of 5 years. Also, to examine changes in root filling quality following root canal retreatment for technical reasons. This retrospective study included radiographs of 441 root-filled roots without periapical radiolucencies at baseline, scheduled for post and core treatment. Follow-up data for a minimum of 5 years were available for 305 roots (loss to follow-up 30.8%), 46 of which were retreated for technical reasons. Two calibrated observers assessed root filling sealing quality and length, respectively, and periapical status according to the Periapical Index. The main outcome of the study, AP, was used as the dependent variable and all analyses were performed at root level. The overall frequency of AP at follow-up was 13.8%. The difference in frequency of AP between retreated (4.3%) and nonretreated (15.4%) root canals was not statistically significant, p = .061. Analyses including only roots with preoperatively inadequate root filling quality showed a statistically significant difference (p = .017) between the two treatment groups (2.4% vs. 22.9%). Root canal retreatment for technical reasons before post and core placement significantly reduces the frequency of AP in roots with inadequate root filling quality.

Long-term assessment of resilience of avian assemblages following a major hurricane

Strong tropical cyclones directly devastate forest habitats and indirectly affect forest-dependent animals. Many forecast models suggest cyclone intensity and size will increase as a result of climate change, and cyclone frequency also may increase. Short-term effects of strong cyclones on vertebrate assemblages are well documented, but we know little about longer-term effects. From 1997 to 2013 we monitored avian assemblages at tropical forest in southern Belize, a forest that was largely destroyed by category 4 Hurricane Iris in October 2001. We found little change in recruitment or species richness, but evenness dropped markedly the first two sampling efforts after the hurricane and species turnover (β diversity) did not stabilize until 6–9 years afterward. Body condition dropped immediately after the hurricane passed but recovered quickly. That population size of resident tropical, but not Neotropical migrant, bird species dropped across our 17-year study highlights the potential urgency of altered cyclonic activity: on average, a hurricane strikes Belize once per decade, yet an increase in frequency, to say nothing of destructive power, could serve to erode extant species associations, lead to local extirpation of forest-dependent species, and create novel, transitory assemblages whose chief characteristic is instability.

Visual Outcome after Cataract Surgery in a South-Eastern Nigerian Tertiary Hospital

Background: Cataract is the leading cause of reversible blindness worldwide. Aim: To evaluate the visual outcome of cataract surgeries done in a South-Eastern tertiary hospital. Methodology: The study is a 2-year retrospective study from January 2021 to December 2022. Case notes of all eligible patients that had cataract surgery within the study period were pulled out and relevant information extracted from them. Collected data was analyzed using SPSS version 21. Results were presented in percentages, tables and pie charts. Results: One hundred and eighty-two eyes were analyzed. Visual outcome continued to improve postoperatively in majority of the patients from first day to 3 months and was even better in some when corrected with glasses or with pinhole. The overall visual outcome was good in 70.3% and poor in 10.4% at 3 months. The major causes of poor visual outcome were aphakia and advanced glaucoma. Conclusion: The overall visual outcome after cataract surgery in these patients did not meet the WHO standard. Thus, there is need for training and re-training of the cataract surgeons, good patients’ selection, in-depth pre-operative work up as well as centre-based provision of needed equipments/ consumables in other to improve the visual outcome.

Defining "High Recurrence" of Depressive Episodes for Predicting Diagnostic Conversion from Major Depressive Disorder to Bipolar Disorder: A 5-year Retrospective Study.

This study determined the threshold for recurrent depressive episodes that predicted conversion from major depressive disorder (MDD) to bipolar disorder (BD). We retrospectively reviewed the medical records of 296 patients diagnosed with MDD for a minimum of 5 years in two university hospitals. We examined their the Diagnostic and Statistical Manual of Mental Disorders, 5th edition diagnoses and detailed clinical information at the initial admission and yearly assessments after discharge to establish the threshold for recurrent depressive episodes indicating a risk of diagnostic conversion from MDD to BD. Optimal cut-offs were derived using receiver operating characteristic (ROC) curves. ROC curve analysis revealed that more than four recurrent depressive episodes was indicative of potential diagnostic conversion from MDD to BD (area under the curve, 0.604; sensitivity, 0.353; specificity, 0.855; positive predictive value, 0.421; negative predictive value, 0.816). These findings suggest that the best predictor of conversion from MDD to BD is more than four recurrent depressive episodes. Our findings have the potential to enhance diagnostic accuracy and treatment efficiency. To validate our results, longitudinal prospective studies are necessary.

Prevalence and presentation of uterine fibroid in a private hospital in Enugu: A 5-year retrospective study

Background: Fibroids are the commonest benign tumours of the uterus. They occur more commonly in the nulliparous women, and among the blacks. They are frequently found incidentally on ultrasonography but common presenting symptoms are abdominal swelling, heavy menstrual bleeding and sub-fertility. Surgery is the definitive treatment modality with most women having myomectomy to preserve fertility. Aim: The aim of this study was to determine the prevalence, presentation and treatment outcomes of fibroid cases treated in the centre. Result: From the study, 42 patients were diagnosed with uterine fibroids over the 5-year period out of a total of 338 gynaecological patients treated in the hospital. This gave a prevalence of 12.42% in the 5-year period. Majority of them, 20(47.6%) were aged 31-40 years, 13(31%) were between 21 and 30 years whereas only 9(21.4%) were aged 41 years and above. Almost all the patients 38(90.5%) were from the Igbo ethnic group; 21(50%) had secondary education while 19(45.2%) had tertiary education. Twenty of them (47.6%) were either civil servants or professionals, 19(42.5%) were traders and 3(7.1%) were unemployed. It also revealed that 22(52.4%) were nulliparous, 11(16.7%) were multiparous and only 2(4.8%) were grand multiparous. More than a quatre of the patients 17(40.5%) presented with abdominal swelling, 14(33.3%) with heavy menses, 8(19%) with infertility and the least 3(7.2%) with recurrent miscarriages. Almost all of them 38(90.5%) had myomectomy and only 4(9.5%) had hysterectomy. Only the age and occupation of the patients had a statistically significant influence on the prevalence of uterine fibroid among the women studied. Conclusion: Most of the women who had uterine fibroids were within the age bracket of 31-40 years with heavy menstrual bleeding as the major presenting symptom. Almost all of them had myomectomy as the definitive treatment.

Investigating the effect of plant growth regulators in the endodormancy release in apricot by a metabolomic approach

AbstractEndodormancy is one of the most studied physiological processes in perennial plants like apricot. This period is vital both for the tree survival against the adverse climatic conditions of winter and for obtaining a proper flowering and fruit set. Many studies have remarked the importance of chill accumulation as the limiting factor for endodormancy release. The increase of mean temperatures caused by climate change has been seriously endangering this process during the last decades. Because of this, plant growth regulators for promoting endodormancy release have spread worldwide. However, due to the toxicity and the irregular efficiency, there is a great necessity of developing new environment-friendly regulators for promoting endodormancy release. In this 3-year study, we applied four different commercial plant growth regulators to the Flopría apricot cultivar. Two of them, Broston® and Erger® were the most effective ones to advance endodormancy release. The physiology and biochemistry behind these treatments were studied by a non-target metabolomic and expression analysis in flower buds. Metabolic groups, like phospholipids, only varied in treated samples, whereas others like by-products of L-Phe metabolism, or ABA significantly varied in both types of samples throughout endodormancy release. Finally, to validate these results, solutions of phospholipids, phenylpropanoids, or ABA, among others, were applied for the first time to apricot trees, showing, i.e., that phospholipids treated-trees released from endodormancy two weeks earlier than control. This study aims to be an initial stage for the elaboration of environmentally safe regulators in apricot, with a potential in other Prunus and temperate fruit tree species.

Letter in response to “Frequency of asymptomatic neurosyphilis in patients with latent syphilis: A 4-year retrospective study from a tertiary care center”

Letter in response to “Frequency of asymptomatic neurosyphilis in patients with latent syphilis: A 4-year retrospective study from a tertiary care center”

A 2-year longitudinal study examining the change in psychosocial factors under the COVID-19 pandemic in Japan

To examine changes in individuals’ psychosocial variables (e.g., psychological distress, social isolation, and alcohol use) during the prolonged COVID-19 pandemic, a two-year longitudinal survey was conducted at approximately one-year intervals between May 2020 and May 2022, after the first COVID-19-related state of emergency was announced in Japan. The online survey was conducted on May 11-12, 2020 (Phase 1), June 14–20, 2021 (Phase 2), and May 13–30, 2022 (Phase 3). The survey in Phase 1 was conducted during the first emergency declaration period, the survey in Phase 2 was conducted during the third emergency declaration period, and the survey in Phase 3 was conducted at a time when there was no state of emergency but many COVID-19 positive cases. Notably, 3,892 participants responded to all three surveys. In addition to psychosocial inventories often used worldwide, survey items included lifestyle and stress management indicators related to COVID-19 and various sociodemographic items including occupation (e.g., healthcare workers) or income, history of medical treatment for mental problems, severe physical illnesses, and COVID-19.

Epidemiology of Maxillofacial Fracture Injury in a Hospital in Xi'an: A 2-Year Retrospective Study.

Despite their limitations, epidemiological studies provide information useful for formulating effective and efficient injury prevention strategies. The aim is to carry out an epidemiology study of maxillofacial fracture in Xijing Hospital. Level of Evidence: Level II-therapeutic study.

Association of NOTCH3 Variant Risk Category With 2-Year Clinical and Radiologic Small Vessel Disease Progression in Patients With CADASIL.

Pathogenic variants in NOTCH3 are the main cause of hereditary cerebral small vessel disease (SVD). SVD-associated NOTCH3 variants have recently been categorized into high risk (HR), moderate risk (MR), or low risk (LR) for developing early-onset severe SVD. The most severe NOTCH3-associated SVD phenotype is also known as cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). We aimed to investigate whether NOTCH3 variant risk category is associated with 2-year progression rate of SVD clinical and neuroimaging outcomes in CADASIL. A single-center prospective 2-year follow-up study was performed of patients with CADASIL. Clinical outcomes were incident stroke, disability (modified Rankin Scale), and executive function (Trail Making Test B given A t-scores). Neuroimaging outcomes were mean skeletonized mean diffusivity (MSMD), normalized white matter hyperintensity volume (nWMHv), normalized lacune volume (nLV), and brain parenchymal fraction (BPF). Cox regression and mixed-effect models, adjusted for age, sex, and cardiovascular risk factors, were used to study 2-year changes in outcomes and differences in disease progression between patients with HR-NOTCH3 and MR-NOTCH3 variants. One hundred sixty-two patients with HR (n = 90), MR (n = 67), and LR (n = 5) NOTCH3 variants were included. For the entire cohort, there was 2-year mean progression for MSMD (β = 0.20, 95% CI 0.17-0.23, p = 7.0 × 10-24), nLV (β = 0.13, 95% CI 0.080-0.19, p = 2.1 × 10-6), nWMHv (β = 0.092, 95% CI 0.075-0.11, p = 8.8 × 10-20), and BPF (β = -0.22, 95% CI -0.26 to -0.19, p = 3.2 × 10-22), as well as an increase in disability (p = 0.002) and decline of executive function (β = -0.15, 95% CI -0.30 to -3.4 × 10-5, p = 0.05). The HR-NOTCH3 group had a higher probability of 2-year incident stroke (hazard ratio 4.3, 95% CI 1.4-13.5, p = 0.011), and a higher increase in MSMD (β = 0.074, 95% CI 0.013-0.14, p = 0.017) and nLV (β = 0.14, 95% CI 0.034-0.24, p = 0.0089) than the MR-NOTCH3 group. Subgroup analyses showed significant 2-year progression of MSMD in young (n = 17, β = 0.014, 95% CI 0.0093-0.019, p = 1.4 × 10-5) and premanifest (n = 24, β = 0.012, 95% CI 0.0082-0.016, p = 1.1 × 10-6) individuals. In a trial-sensitive time span of 2 years, we found that patients with HR-NOTCH3 variants have a significantly faster progression of major clinical and neuroimaging outcomes, compared with patients with MR-NOTCH3 variants. This has important implications for clinical trial design and disease prediction and monitoring in the clinic. Moreover, we show that MSMD is a promising outcome measure for trials enrolling premanifest individuals.

Machine Learning for Identifying Emergent and Floating Aquatic Vegetation from Space: A Case Study in the Dniester Delta, Ukraine

Monitoring aquatic vegetation, including both floating and emergent types, plays a crucial role in understanding the dynamics of freshwater ecosystems. Our research focused on the Lower Dniester Basin in Southern Ukraine, covering approximately 1800 square kilometers of steppe plains and wetlands. We applied traditional machine learning algorithms, specifically random forest and boosting trees, to analyze Sentinel-2 satellite imagery for segmenting aquatic vegetation into emergent and floating types. Our methodology was validated against detailed in-situ field measurements collected annually over a 5-year study period. The machine learning classifiers achieved an F1-score of 0.88 ± 0.03 in classifying floating vegetation, outperforming our previously suggested histogram-based thresholding methodology for the same task. While emergent vegetation and open water were easily identifiable from satellite imagery, the robustness and temporal transferability of our methodology included accurately delineating floating vegetation as well. Additionally, we explored the significance of various features through the Minimum Redundancy - Maximum Relevance algorithm. This study highlights advancements in aquatic vegetation mapping and demonstrates a valuable tool for ecological monitoring and future research endeavors.

Corrigendum: Relationship between the longitudinal trajectory of the triglyceride-glucose index and the development of CKD: an 8-year retrospective longitudinal cohort study

Corrigendum: Relationship between the longitudinal trajectory of the triglyceride-glucose index and the development of CKD: an 8-year retrospective longitudinal cohort study

Meticulous catheter care and aseptic approach reduce catheter-related bloodstream infections significantly in hemodialysis patients: A 5-year single center study.

The use of central venous catheters as hemodialysis vascular access is a major contributor to high bloodstream infection rate. In our dialysis unit in Shenzhen Guangdong Province China, we have developed and used our own dialysis catheter care protocol since May 2013 with good results. In this study, we would like to share our experience with the other units. We have undertaken a 5-year retrospective analysis to determine our tunneled dialysis catheter-related blood stream infection rate by adding the number of infections divided by total number of catheter days × 1000. The results were compared with another study carried out in Henan Province China. Demographic data were summarized using descriptive statistics. Continuous and categorical variables were compared using t-test and χ2 test respectively. Between 2017 and 2021, a total of 216 tunneled dialysis catheters were managed by following our own dialysis access pathway and catheter care protocol. The tunneled dialysis catheter-related bloodstream infection rate was 0.0229 per 1000 catheter days in the 5-year period. Comparing with other published studies in China, our unit has achieved a very low rate of tunneled dialysis catheter-related bloodstream infection which has been sustained over time. This paper explores how our protocol and implementation might have contributed to the results.

Diagnostic accuracy and clinical impact of renal biopsy cytology.

The role of fine needle biopsy cytology in the workup of renal mass lesions remains controversial. With advances in imaging technology and clinical management for renal masses, a critical reevaluation of the role of renal biopsy is needed. This study was designed to provide a comprehensive evaluation of the performance and clinical impact of fine needle biopsy in patients with renal masses. A 5-year retrospective study of ultrasound or computer tomography (CT)-guided fine needle biopsies of renal masses diagnosed via cytopathology was conducted. Overall diagnostic rate, sensitivity, and diagnostic accuracy were calculated. Further analysis of the impact of fine needle biopsy cytology on clinical management was performed. A total of 227 cases of fine-needle aspiration and/or biopsy (FNA/B) of renal masses were identified, including 76 with subsequent nephrectomies. Complications were rare (<1%). The diagnostic rate and sensitivity of FNA/B were 83.3% and 89.5%, respectively. Diagnostic accuracy was 98.7% at the major categorical level and 94.7% at the tumor subtype level. Subsequent clinical actions were associated with a definitive cytologic diagnosis of malignancy/neoplasia (p < .05) and were affected by tumor subtype (p < .05). This study demonstrates that FNA/B of renal masses is a safe and reliable minimally invasive diagnostic tool with excellent accuracy in confirmation of malignancy and subclassification of tumors. Diagnoses made on FNA/B play a key role in guiding a personalized clinical treatment plan.

Structural and functional characterization of retinal impairment in T1DM patients without diabetic retinopathy: a 3-year longitudinal study.

To analyze the progression of structural and functional retinal impairment in type 1 diabetes mellitus (T1DM) patients with no clinical signs of diabetic retinopathy (DR) during a 3-year follow-up. This was an observational longitudinal study. Post-pediatric T1DM patients without clinical signs of DR, and sex- and age-matched healthy subjects were recruited at San Raffaele Hospital (Milan, Italy). Each patient underwent a comprehensive ophthalmological evaluation, including optical coherence tomography (OCT), OCT-angiography (OCT-A), retinal static and dynamic vessel analysis (DVA), and microperimetry. 21 eyes of 21 T1DM patients (10 females; 24 ± 2years old), and 21 age and sex-matched healthy subjects were enrolled. At baseline, T1DM eyes revealed a significantly decreased vessel length density using OCT-A (p < 0.001 and p = 0.046 in 3 × 3 and 6 × 6mm images) and a significantly increased vessel density index (p = 0.013 and p = 0.087 in 3 × 3 and 6 × 6mm images) of deep capillary plexus. DVA detected a significantly decreased vessel response to flicker light (p = 0.002). A significantly increased thickness of ganglion cellular layer 6-mm-diameter subfields in inferior and superior quadrants was found in diabetic patients (p < 0.001 in both subfields). At 3-years-follow-up no significant longitudinal changes were disclosed in all analyses. Concomitant subclinical microvascular and neurodegenerative damages could be early signs of DR onset that precede functional alterations and clinical signs of DR development. These alterations demonstrated a stable trend over time.

Comparing percutaneous transhepatic papillary balloon dilation with endoscopic retrograde cholangiopancreatography in elderly patients for common bile duct stones: a 3-year retrospective study.

To assess the safety and effectiveness of PTPBD for CBD stones in the elderly population. Patients aged 60years or older, who underwent PTPBD or ERCP for CBD stones between January 2021 and December 2023, were included in this study and divided into either the PTPBD group or the ERCP group based on the procedure they underwent. Baseline characteristics, intraoperative and postoperative outcomes were collected and analyzed using SPSS 25.0. A total of 145 cases were enrolled in the study. In terms of intraoperative complications, one patient in the ERCP group experienced hemorrhaging, while one patient in the PTPBD group experienced acute pain. However, neither of these patients were in a serious condition and only required observation. Stone removal procedures were successfully conducted in approximately 95% of cases in both the PTPBD and ERCP groups (95.8 and 94.8%, respectively; P > 0.999). ERCP failures were observed in one patient with a previous Billroth II anastomosis and two patients with unconventional anatomy of the esophagus and stomach. There was no statistically significant difference in postoperative complications between the PTPBD group and the ERCP group (P > 0.05). The length of hospital stays did not differ between the PTPBD group and the ERCP group (P = 0.537 > 0.05). PTPBD can be used in patients who have complicated anatomical issues that make the ERCP procedure difficult. In comparison, PTPBD is a similarly safe, effective, and minimally invasive technique for extracting CBD stones in elderly patients.