Objective To explore the clinical utility of endoclip papilloplasty in endoscopic retrograde cholangiopancreatography(ERCP).Methods A prospective study was conducted and selected 62 patients who underwent ERCP from November 2021 to November 2022.30 out of 32 patients who randomly underwent endoclip papilloplasty were successful.These patients were assigned to successful endoclip papilloplasty group(group A,n=30)or the duodenal papilla unclamping group(group B,n=30).The aim was to compare the difference in short-term and long-term complications between the two groups.Results The success rate of papillary plasty was 93.8%(30/32),with no statistically significant differences observed in the incidence of postoperative pancreatitis,postoperative hemorrhage after ERCP,and postoperative cholangitis between the two groups(P>0.05).The duodenal perforation rate was 0.There were no significant differences between the two groups in terms of total cholangitis incidence and recurrence rate of calculus of common bile duct within 1 year(P>0.05).However,there was a statistical difference in terms of total the incidence of cholangitis+calculus of common bile duct recurrence within 1 year(P<0.05).Conclusion The endoclip papilloplasty exhibits a high success rate and safety and feasibility procedure reducing long-term recurrence rate of cholangitis and calculus of common bile duct in endoscopic papillary large balloon dilation(EPLBD)procedure.

Objective:To investigate the safety and efficacy of using the self-designed C/S-J type self-releasing biliary stent for biliary drainage after endoscopic retrograde cholangiopancreatography(ERCP).Methods:A total of 184 patients with common bile duct stones admitted from October 2015 to October 2018 were allotted to three groups,and underwent ERCP and endoscopic sphincterotomy(EST)plus internal drainage with C/S-J type self-releasing biliary stent(C/S-J group,104 cases),ERCP and EST plus endoscopic nasobiliary drainage ENBD(ENBD group,40 cases),and ERCP and EST plus endoscopic retrograde biliary drainage(ERBD)(ERBD group,40 cases),respectively.The incidence rates of post-ERCP acute pancreatitis(PEP)and acute cholangitis among groups were compared,and the evacuation time of the self-releasing biliary stent in C/S-J group was observed.Results:There were no differences in sex,age,stone size,number of stones,previous cholecystectomy and presence or absence of cholangitis among the three groups(all P>0.05).In C/S-J group,ENBD group and ERBD group,the incidence rates of PEP were 6.73%(7/104),7.50%(3/40)and 10.00%(4/40),and the incidence rates of cholangitis were 0.96%(1/104),0.00%(0/40)and 2.50%(1/40)respectively,and the differences among groups showed no significance(both P>0.05).In C/S-J group,the stent in two cases was shed and evacuated on the first day after ERCP,the stent in one case failed to evacuate 3 months after ERCP and then was removed with duodenoscope,and the stent in the remaining cases evacuated through the digestive tract within 9-14 d with an average of 10.2 d after ERCP,and no complications such as obstruction,perforation and bleeding of the digestive tract occurred.Conclusion:Using the self-designed C/S-J type self-releasing biliary stent for post-ERCP biliary drainage is safe and effective,and it also can overcome the limitations of ENBD and ERBD.

Objective:To investigate the safety and efficacy of using the self-designed C/S-J type self-releasing biliary stent for biliary drainage after endoscopic retrograde cholangiopancreatography(ERCP).Methods:A total of 184 patients with common bile duct stones admitted from October 2015 to October 2018 were allotted to three groups,and underwent ERCP and endoscopic sphincterotomy(EST)plus internal drainage with C/S-J type self-releasing biliary stent(C/S-J group,104 cases),ERCP and EST plus endoscopic nasobiliary drainage ENBD(ENBD group,40 cases),and ERCP and EST plus endoscopic retrograde biliary drainage(ERBD)(ERBD group,40 cases),respectively.The incidence rates of post-ERCP acute pancreatitis(PEP)and acute cholangitis among groups were compared,and the evacuation time of the self-releasing biliary stent in C/S-J group was observed.Results:There were no differences in sex,age,stone size,number of stones,previous cholecystectomy and presence or absence of cholangitis among the three groups(all P>0.05).In C/S-J group,ENBD group and ERBD group,the incidence rates of PEP were 6.73%(7/104),7.50%(3/40)and 10.00%(4/40),and the incidence rates of cholangitis were 0.96%(1/104),0.00%(0/40)and 2.50%(1/40)respectively,and the differences among groups showed no significance(both P>0.05).In C/S-J group,the stent in two cases was shed and evacuated on the first day after ERCP,the stent in one case failed to evacuate 3 months after ERCP and then was removed with duodenoscope,and the stent in the remaining cases evacuated through the digestive tract within 9-14 d with an average of 10.2 d after ERCP,and no complications such as obstruction,perforation and bleeding of the digestive tract occurred.Conclusion:Using the self-designed C/S-J type self-releasing biliary stent for post-ERCP biliary drainage is safe and effective,and it also can overcome the limitations of ENBD and ERBD.

Objective To design and create a C/S-J type of biliary self-releasing stent,and to study its safety and efficacy in preventing post-ERCP complications.Methods 118 patients with common bile duct stones treated in our hospital were enrolled into this study from October 2013 to May 2015.These patients were randomly divided into two groups:the experimental group who underwent ERCP + EST + C/S-J type of self-releasing biliary stent drainage,while the control group underwent ERCP + EST + ENBD.The incidences of post-ERCP acute pancreatitis (PEP) and cholangitis in the two groups and the time the self-releasing stent was dislodged from the biliary system in the experimental group were recorded.Results The incidence of PEP was 6.4％ (5/78) and 7.5％ (3/40) in the experimental and the control group,respectively (P ＞ 0.05).There were no patients who developed postoperative acute cholangitis in the two groups.The stents were dislodged from the biliary system on the first day after the procedure in 2 patients in the experimental group without any complications.One stent failed in self-releasing but was removed successfully with endoscopy 3 months later.In the other 75 patients,the stents were successfully dislodged and were excreted outside the patient's body through the intestinal tract (mean 11.4,range 9 ～ 14) days,without any complications.Conclusion The C/S-J type of biliary self-releasing stents is safe and efficacious in preventing post-ERCP pancreatitis and cholangitis.