Clinical spotlight review for the management of choledocholithiasis

Narula, Vimal K.; Fung, Eleanor C.; Overby, D. Wayne; Richardson, William; Bacon, Simon L.

doi:10.1007/s00464-020-07462-2

“…Endoscopic retrograde cholangiopancreatography (ERCP) has been used as an important clinical treatment in terms of removing choledocholithiasis and relieving the obstructive jaundice; this method has the advantages of less trauma, good curative effect, and quick recovery, and its efficacy and safety have been widely recognized [ 1 ]. Some patients with duodenal bulb ulcers have had posterior duodenal bulb stenosis at the time of treatment, which can form an ectopic nipple lift opening, resulting in poor bile excretion and choledocholithiasis [ 2 ]. Prospective data reveal that 10% of adults will develop symptomatic gallstones over the course of a decade in America, and 10–20% of those have concomitant choledocholithiasis [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Application of ERCP Procedures in Choledocholithiasis with Duodenal Stenosis Patients

Shi

¹

,

Zhong

²

,

Zhou

³

et al. 2022

Evidence-Based Complementary and Alternative Medicine

View full text Add to dashboard Cite

Objective. The treatment of choledocholithiasis with duodenal stenosis is a clinical difficult problem. This study aimed to investigate the efficacy and safety of ERCP via gastroscopy in the treatment of choledocholithiasis and duodenal stenosis. Methods. From January 2015 to December 2020, 21 patients with choledocholithiasis with duodenal stenosis who underwent ERCP treatment under gastroscopy in our hospital were enrolled. The patients’ case characteristics, ERCP status, and complication rate were analyzed. Results. Among the 21 patients, 17 cases were successful in ERCP, and a total of 29 times ERCPs were performed, with an average of 1.71 times per patient. Among the failures of ERCP, selective deep intubation of common bile duct was unsuccessful in 4 cases. Six patients underwent multiple lithotomies, after the operation, of which 4 patients underwent secondary ERCP lithotomy and 2 patients underwent triple ERCP lithotomy. All patients successfully completed the balloon dilation without serious complications. Two patients developed mild acute pancreatitis after ERCP, and all recovered after medication. Conclusion. In patients with choledocholithiasis and duodenal stenosis, ERCP treatment by gastroscopy has a higher success rate and does not increase the incidence of complications, but there is a problem of cholecystolithiasis recurrence.

show abstract

“…It is not only a disease with a high incidence and a high incidence in China but also has a high incidence in the world. According to relevant statistical reports, about 10%~15% of European adult population suffer from gallstone disease, and the incidence of gallbladder stones combined with choledocholithiasis in patients with gallstone disease is 10%~20% [21,22]. There are also related statistics suggesting that in the United States, there are about 2,000 new cases of gallstones appearing every year.…”

Section: Discussionmentioning

confidence: 99%

Artificial Intelligence‐Assisted Visual Sensing Technology under Duodenoscopy of Gallbladder Stones

Li

¹

,

Bin

²

,

Shen

³

et al. 2021

Journal of Sensors

0

View full text Add to dashboard Cite

Objective. This study is aimed at exploring the application effect of duodenoscopy assisted by visual sensing technology based on convolutional neural network (CNN) segmentation algorithm in the diagnosis and treatment of gallbladder stones, so as to provide safer and more effective treatment methods for patients with gallstones. Methods. 188 patients with gallstones and choledocholithiasis who were admitted to our hospital from January 2016 to April 2021 were selected as the research objects. Based on whether the patients were willing to use AI-assisted visual sensing technology during the treatment process, all patients were divided into two groups, namely, the AI group and the conventional group. Various surgical indicators of patients in two groups were compared. Results. The precision, recall, and mean intersection ratio of the M-Unet-based segmentation algorithm were 94.56%, 96.56%, and 98.92%, respectively. In the AI group, the operation time ( 2.74 ± 0.45 h ), postoperative drainage tube placement time ( 4.31 ± 1.15 d ), time required for recovery of gastrointestinal function ( 1.74 ± 0.54 d ), time required to get out of bed ( 1.14 ± 0.55 h ), and time spent in hospital ( 9.94 ± 1.45 d ) were all shorter compared with those in the conventional group, which were 3.21 ± 0.32 h , 12.14 ± 2.98 d , 2.89 ± 0.67 d , 2.09 ± 0.87 h , and 14.14 ± 1.15 h , showing statistical differences ( P < 0.05 ); the intraoperative blood loss ( 79.74 ± 6.45 mL ) and residual status of stones (0%) in the AI group were much lower than those in the conventional group ( P < 0.05 ). In addition, the incidence of complications (10.26%) and the indicators of postoperative gallbladder function of patients in the AI group were lower greatly than those in the conventional group ( P < 0.05 ). Conclusion. The visual sensing technology assisted by the CNN algorithm showed a good effect on image processing, and endoscopic technology can effectively improve the treatment effect of gallbladder stones combined with choledocholithiasis with the aid of this technology. Therefore, the conclusion in this study proved that visual sensing technology based on intelligent algorithms showed a good future in the medical field.

show abstract

“…Los modelos de predicción tienen como fin estratificar a los pacientes en diferentes grupos de riesgo sobre los cuales se determina la necesidad de métodos diagnósticos y estrategias de tratamiento (17,18) . Algunos modelos categorizan al paciente en dos grupos de riesgo (bajo y alto) (19) , otros en tres grupos (bajo, medio y alto) (3,5,20) y otros en subgrupos más específicos (bajo, medio-bajo, medio-alto, alto) (7,12,21,22) . Algunos ejemplos de este tipo de modelos son el de la Sociedad Americana de Gastroenterología y Endoscopia (SAGES) (5,20) y el de la Sociedad Europea de Gastroenterología y Endoscopia (ESGE) (3) .…”

Section: Variables Incluidas En Los Modelos De Predicción E Interacción De Las Mismasunclassified

“…Algunos modelos categorizan al paciente en dos grupos de riesgo (bajo y alto) (19) , otros en tres grupos (bajo, medio y alto) (3,5,20) y otros en subgrupos más específicos (bajo, medio-bajo, medio-alto, alto) (7,12,21,22) . Algunos ejemplos de este tipo de modelos son el de la Sociedad Americana de Gastroenterología y Endoscopia (SAGES) (5,20) y el de la Sociedad Europea de Gastroenterología y Endoscopia (ESGE) (3) .…”

Section: Variables Incluidas En Los Modelos De Predicción E Interacción De Las Mismasunclassified

Luces y sombras en la predicción de coledocolitiasis: oportunidades para la investigación futura

Contreras

¹

,

Domínguez-Torres

²

,

Rueda³

2021

Rev. colomb. Gastroenterol.

1

0

View full text Add to dashboard Cite

La coledocolitiasis secundaria es una entidad de alta prevalencia que involucra desafíos de diagnóstico y tratamiento; asimismo, genera un elevado uso de recursos y costo económico. Existen múltiples vacíos de conocimiento con respecto a los modelos de predicción clínica para el diagnóstico, estratificación en grupos de riesgo y manejo de pacientes con coledocolitiasis secundaria. Los principales vacíos recaen sobre su rendimiento diagnóstico, variables incluidas y umbrales de riesgo, así como sobre su costo-efectividad para el uso de recursos no invasivos e invasivos, y aplicación en grupos poblacionales especiales. Este artículo ahonda estos vacíos de conocimiento y propone una agenda que puede orientar la investigación futura.

show abstract

Clinical spotlight review for the management of choledocholithiasis

Cited by 40 publications

References 39 publications

Application of ERCP Procedures in Choledocholithiasis with Duodenal Stenosis Patients

Application of ERCP Procedures in Choledocholithiasis with Duodenal Stenosis Patients

Artificial Intelligence‐Assisted Visual Sensing Technology under Duodenoscopy of Gallbladder Stones

Luces y sombras en la predicción de coledocolitiasis: oportunidades para la investigación futura

Contact Info

Product

Resources

About