Clinical value of endoclip papillaplasty for preventing recurrent choledocholithiasis after endoscopic retrograde cholangiopancreatography (with video)
10.3760/cma.j.cn321463-20240324-00168
- VernacularTitle:内镜夹闭乳头成形术在预防内镜逆行胰胆管造影术后胆总管结石复发中的临床价值（含视频）
- Author:
Bowei LIU
1
;
Wei WANG
;
Min XU
;
Xiaoyu MAO
;
Lijie YUAN
;
Yuchen ZHANG
;
Shengli NIU
;
Xiuqi WANG
;
Xiuling LI
;
Luowei WANG
;
Hui DING
Author Information
1. 郑州大学人民医院 河南省人民医院消化内科，郑州450000
- Publication Type:Journal Article
- Keywords:
Cholangiopancreatography, endoscopic retrograde;
Endoclip papillaplasty;
Endoscopic sphincterotomy;
Choledocholithiasis;
Recurrence
- From:
Chinese Journal of Digestive Endoscopy
2025;42(7):532-538
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical efficacy of endoclip papillaplasty (ECPP) for preventing recurrent choledocholithiasis after endoscopic retrograde cholangiopancreatography (ERCP).Methods:A retrospective analysis was conducted on 1 941 patients who underwent ERCP for choledocholithiasis in Henan Provincial People's Hospital from January 2019 to December 2023. A total of 250 patients who received ECPP were assigned to the ECPP group, while 251 matched controls were selected via 1∶1 year-stratified sampling into the control group. After follow-up, 209 ECPP cases and 190 controls were ultimately included in the analysis. Stone removal success rate, incidence of perioperative complications, and postoperative choledocholithiasis recurrence were compared between the two groups. Univariate and multivariate logistic regression were used to determine the risk factors for choledocholithiasis recurrence after ERCP.Results:Both groups achieved 100.0% stone removal success rate. There was no significant difference in the incidence of intraoperative perforation [0.5% (1/209) VS 1.1% (2/190), χ2=0.01, P=0.934], postoperative hyperamylasemia [21.5% (45/209) VS 17.4% (33/190), χ2=1.10, P=0.295] or post-ERCP pancreatitis [3.8% (8/209) VS 8.1% (9/190), χ2=0.20, P=0.653] between the ECPP group and the control group. The ECPP group showed significantly lower bleeding rate [5.1% (11/209) VS 12.3% (23/190), χ2=5.98, P=0.014] and choledocholithiasis recurrence rate [10.5% (22/209) VS 18.9% (36/190), χ2=5.68, P=0.017] compared with the control group. The multivariate logistic regression identified dilated common bile duct diameter ( OR=1.881, 95% CI: 1.101-3.213, P=0.021) as an independent risk factor for choledocholithiasis recurrence, while being female ( OR=0.482, 95% CI: 0.266-0.875, P=0.016) and ECPP ( OR=0.497, 95% CI:0.278-0.887, P=0.018) were protective factors. Conclusion:ECPP effectively reduces choledocholithiasis recurrence rate and bleeding risk after ERCP. ECPP and being female serve as protective factors for choledocholithiasis recurrence, while dilated bile duct diameter is an independent risk factor.
