Extracorporeal shock wave lithotripsy for difficult common bile duct stones: a comparison between 2 different lithotripters in a large cohort of patients

Cecinato, Paolo; Fuccio, Lorenzo; Azzaroli, Francesco; Lisotti, Andrea; Correale, Loredana; Hassan, Cesare; Buonfiglioli, Federica; Cariani, Giulio; Mazzella, Giuseppe; Bazzoli, Franco; Muratori, Rosangela

doi:10.1016/j.gie.2014.04.059

Cited by 17 publications

(9 citation statements)

References 26 publications

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“…Therefore, ESWL overcomes the problem of the stone size by fragmenting the stones and reducing the stone burden, thus facilitating endoscopic clearance in the following ERCP procedure. According to the literature, complete clearance of CBD stones can be achieved in 40%-75% of the patients[18,19]. …”

Section: Discussionmentioning

confidence: 99%

Outcome of a session of extracorporeal shock wave lithotripsy before endoscopic retrograde cholangiopancreatography for problematic and large common bile duct stones

Tao

Zhang

et al. 2017

WJG

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AIMTo compare the efficacy of a session of extracorporeal shock wave lithotripsy (ESWL) before endoscopic retrograde cholangiopancreatography (ERCP) vs ERCP only for problematic and large common bile duct (CBD) stones.METHODSAdult patients with CBD stones for whom initial ERCP was unsuccessful because of the large size of CBD stones were identiﬁed. The patients were randomized into two groups, an “ESWL + ERCP group” and an “ERCP-only” group. For ESWL + ERCP cases, ESWL was performed prior to ERCP. Clearance of the CBD, complications related to the ESWL/ERCP procedure, frequency of mechanical lithotripsy use and duration of the ERCP procedure were evaluated in both groups.RESULTSThere was no significant difference in baseline characteristics between the two groups. A session of ESWL before ERCP compared with ERCP only resulted in similar outcomes in terms of successful stone removal within the first treatment session (74.2% vs 71.0%, P = 0.135), but a higher clearance rate within the second treatment session (84.4% vs 51.6%, P = 0.018) and total stone clearance (96.0% vs 86.0%, P = 0.029). Moreover, ESWL prior to ERCP not only reduced ERCP procedure time (43 ± 21 min vs 59 ± 28 min, P = 0.034) and the rate of mechanical lithotripsy use (20% vs 30%, P = 0.025), but also raised the clearance rate of extremely large stones (80.0% vs 40.0%, P = 0.016). Post-ERCP complications were similar for the two groups.CONCLUSIONBased on the higher rate of successful stone removal and minimal complications, ESWL prior to ERCP appears to be a safe and effective treatment for the endoscopic removal of problematic and large CBD stones.

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Section: Discussionmentioning

confidence: 99%

Outcome of a session of extracorporeal shock wave lithotripsy before endoscopic retrograde cholangiopancreatography for problematic and large common bile duct stones

Tao

Zhang

et al. 2017

WJG

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“…C e c i n a t oe ta l . 2015 [12] 378 ance rate, complete ductal clearance after the first session, complete stone fragmentation rate, and overall morbidity rate. However, no significant difference was found for post-procedural and anesthesia-related complication rates.…”

Section: Referencementioning

confidence: 99%

A systematic review of advanced endoscopy-assisted lithotripsy for retained biliary tract stones: laser, electrohydraulic or extracorporeal shock wave

et al. 2018

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“…ERCP failure to extract stones may be due to failed cannulation (i.e., Juxta-papillary diverticulum, intra-diverticular papilla or small papilla), or failed extraction [ [35] , [36] , [37] , [38] , [39] ]. The failed extraction occur with difficult stones (i.e Mirrizi's syndrome, stricture of the lower CBD, impacted, large (<15 mm), multiple (<3), or intrahepatic duct/cystic duct stones), especially when using standard methods (balloon or basket after ES or endoscopic papillary balloon dilatation (EPBD)) [ 39 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical (Open and laparoscopic) management of large difficult CBD stones after different sessions of endoscopic failure: A retrospective cohort study

Gad

Zakaria

Kamel

et al. 2019

Annals of Medicine and Surgery

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Objectives For complicated common bile duct stones (CBDS) that cannot be extracted by endoscopic retrograde cholangiopancreatography (ERCP), management can be safely by open or laparoscopic CBD exploration (CBDE). The study aimed to assess these surgical procedures after endoscopic failure. Methods We analyzed 85 patients underwent surgical management of difficult CBDS after ERCP failure, in the period from 2013 to 2018. Results Sixty-seven (78.8%) and 18(21.2%) of our patients underwent single and multiple ERCP sessions respectively. An impacted large stone was the most frequent cause of ERCP failure (60%). Laparoscopic CBDE(LCBDE), open CBDE(OCBDE) and the converted cases were 24.7% (n = 21), 70.6% (n = 60), and 4.7% (n = 4) respectively. Stone clearance rate post LCBDE and OCBDE reached 95.2% and 95% respectively, Eleven (12.9%) of our patients had postoperative complications without mortality. By comparing LCBDE and OCBDE; there was a significant association between the former and longer operative time. On comparing, T-tube and 1ry CBD closure in both OCBDE and LCBDE, there was significantly longer operative time, and post-operative hospital stays in the former. Furthermore, in OCBDE group, choledocoscopy had an independent direction to 1ry CBD repair and significant association with higher stone clearance rate, shorter operative time, and post-operative hospital stay. Conclusion Large difficult CBDS can be managed either by open surgery or laparoscopically with acceptable comparable outcomes with no need for multiple ERCP sessions due to their related morbidities; furthermore, Open choledocoscopy has a good impact on stone clearance rate with direction towards doing primary repair that is better than T-tube regarding operative time and post-operative hospital stay.

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Extracorporeal shock wave lithotripsy for difficult common bile duct stones: a comparison between 2 different lithotripters in a large cohort of patients

Cited by 17 publications

References 26 publications

Outcome of a session of extracorporeal shock wave lithotripsy before endoscopic retrograde cholangiopancreatography for problematic and large common bile duct stones

Outcome of a session of extracorporeal shock wave lithotripsy before endoscopic retrograde cholangiopancreatography for problematic and large common bile duct stones

A systematic review of advanced endoscopy-assisted lithotripsy for retained biliary tract stones: laser, electrohydraulic or extracorporeal shock wave

Surgical (Open and laparoscopic) management of large difficult CBD stones after different sessions of endoscopic failure: A retrospective cohort study

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