Clinical Features and Outcomes of Endoscopic Treatment for Stones in Stemware-Shaped Common Bile Ducts: A Multicenter Data Analysis.
- Author:
Jee Young HAN
1
;
Don Haeng LEE
;
Seok JEONG
;
Hyun Jong CHOI
;
Jong Ho MOON
;
Joung Ho HAN
;
Chang Il KWON
;
Tae Hoon LEE
;
Jong Jin HYUN
;
Jae Chul HWANG
;
Dong Hee KOH
Author Information
- Publication Type:Multicenter Study ; Original Article ; Research Support, Non-U.S. Gov't
- Keywords: Common bile duct; Choledocholithiasis; Mechanical lithotripsy; Cholangiopancreatography, endoscopic retrograde
- MeSH: Adult; Aged; Aged, 80 and over; Cholangiopancreatography, Endoscopic Retrograde/adverse effects/methods; Choledocholithiasis/complications/*surgery; Common Bile Duct/*anatomy & histology/surgery; Endoscopy, Gastrointestinal/adverse effects/*methods; Female; Humans; Lithotripsy/adverse effects/*methods; Male; Middle Aged; Treatment Outcome
- From:Gut and Liver 2015;9(6):800-804
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Various anatomical features of the biliary tree affect ability to remove difficult common bile duct (CBD) stones. In this study, we evaluated the clinical characteristics and outcomes of the endoscopic treatment of stones in stemware-shaped CBDs. METHODS: Thirty-four patients with a stone and a stemware-shaped CBD who were treated at different tertiary referral centers from January 2008 to December 2012 were studied retrospectively. When stone removal failed, percutaneous or direct peroral cholangioscopic lithotripsy, endoscopic retrograde biliary drainage, or surgery was performed as a second-line procedure. RESULTS: The overall success rate of the first-line procedure was 41.2%. Five of the 34 patients (14.7%) experienced procedure-related complications. No procedure-related mortality occurred. Mechanical lithotripsy was required to completely remove stones in 13 patients (38.2%). Conversion to a second-line procedure was required in 20 patients (58.8%). Mechanical lithotripsy was needed in 75% and 66.7% of those with a stone size of <1 cm or > or =1 cm, respectively. Stone recurrence occurred in two patients (9.1%) after 6 months and 27 months, respectively. CONCLUSIONS: The endoscopic treatment of stones in a stemware-shaped CBD is challenging. The careful assessment of difficult CBD stones is required before endoscopic procedures.
