Cholangioscopy-assisted extraction through novel papillary support for small-calibre and sediment-like common bile duct stones.
Autor: | Zhang WG; Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China., Chai NL; Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China., Zhang B; Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China., Li X; Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China., Wang JF; Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China., Dong H; Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China., Feng YJ; Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China., Linghu EQ; Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China. linghuenqiang@vip.sina.com. |
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Jazyk: | angličtina |
Zdroj: | World journal of gastroenterology [World J Gastroenterol] 2023 Apr 28; Vol. 29 (16), pp. 2495-2501. |
DOI: | 10.3748/wjg.v29.i16.2495 |
Abstrakt: | Background: To date, endoscopic retrograde cholangiopancreatography has become a well-established treatment for common bile duct (CBD) stones. However, it is not suitable for some special patients, such as pregnant women, children or those who cannot stop taking anti-coagulation/anti-platelet agents because of radiation injury and the risk of postoperative bleeding resulting from endoscopic sphincterotomy. To overcome these two problems, this study introduced cholangioscopy-assisted extraction through a novel papillary support for small-calibre and sediment-like CBD stones. Aim: To assess the feasibility and safety of cholangioscopy-assisted extraction through a novel papillary support (CEPTS) for small-calibre and sediment-like common bile duct (CBD) stones. Methods: This Retrospective study was approved by the Ethics Committee of the Chinese PLA General Hospital. We designed a covered single dumbbell-style papillary support between 2021 and 2022. Between July 2022 and September 2022, 7 consecutive patients with small-calibre (cross diameter ≤ 1.0 cm) or sediment-like CBD stones underwent CETPS procedures in our center. The clinical characteristics and treatment outcomes of these 7 patients were extracted from a prospectively collected database. And the related data were analyzed. Informed consent was obtained from all participating patients. Results: A total of 2 patients had yellow sediment-like CBD stones, and aspiration extraction was performed after the insertion of papillary support. Of the 5 patients with clumpy CBD stones (0.4-1.0 cm), 2 underwent basket extraction under direct vision for a single stone (0.5-1.0 cm, black and black grey), 1 underwent balloon plus aspiration extraction under direct vision for 5 stones (0.4-0.6 cm, brown), and 2 underwent aspiration extraction only for a single stone (0.5-0.6 cm, yellow, none). Technical success, namely, no residual stones in the CBD or left and right hepatic ducts, was achieved in all 7 cases (100%). The median operating time was 45.0 minutes (range 13.0-87.0 minutes). Postoperative pancreatitis (PEP) occurred in one case (14.3%). Hyperamylasaemia without abdominal pain was noted in 2 of 7 patients. No residual stones or cholangitis were found during the follow-up. Conclusion: CETPS appeared to be feasible to treat patients with small-calibre or sediment-like CBD stones. Patients, especially pregnant women and those who cannot stop anticoagulation/anti-platelet agents, could benefit from this technique. Competing Interests: Conflict-of-interest statement: We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work. (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.) |
Databáze: | MEDLINE |
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