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

Tao, Tao; Zhang, Ming; Zhang, Qijie; Liang, Li; Li, Tao; Zhu, X. G.; Li, Ming-Dong; Liu, Guihua; Sun, Siyu

doi:10.3748/wjg.v23.i27.4950

Cited by 10 publications

(8 citation statements)

References 33 publications

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“…Nevertheless, when EST was used alone, it might fail in larger stones extraction [2]. Whenever applicable, before the ERCP procedure, large bile duct stones removal might need the concomitant use of mechanical lithotripsy (ML) or intraductal electrohydraulic lithotripsy (EHL) or laser lithotripsy, or extracorporeal shock wave lithotripsy [13]. Most endoscopists used EST or EPBD combined with ML to remove large bile duct stones.…”

Section: Introductionmentioning

confidence: 99%

The efficacy of limited endoscopic sphincterotomy plus endoscopic papillary large balloon dilation for removal of large bile duct stones

et al. 2019

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Background The removal of large bile duct stones (> 15 mm) by conventional endoscopic sphincterotomy (EST) and endoscopic papillary balloon dilation (EPBD) can be challenging, requiring mechanical lithotripsy (ML) in addition to EST or EPBD. The primary complication of ML is basket and stone impaction, which can lead to complications such as pancreatitis and cholangitis. The present study aims to investigate the efficacy of limited EST plus endoscopic papillary large balloon dilation (EST-EPLBD) for large bile duct stone extraction with an extent of cutting < 1/2 the length of the papillary mound. Methods We enrolled 185 patients with ≥15 mm bile duct stones who received EST, EPLBD and limited EST-EPLBD treatment from January 1, 2010 to February 28, 2018, at Kaohsiung Chang Gung Memorial Hospital (Kaohsiung, Taiwan). All patients were categorized into three groups: EST group ( n = 31), EPLBD group ( n = 96), and limited EST-EPLBD group ( n = 58). The primary outcome variables were the success rate of complete stone removal and complications. Results The limited EST-EPLBD group exhibited a higher success rate of the first-session treatment compared with the EST and EPLBD groups (98.3% vs. 83.9% vs. 86.5%; P = 0.032) but required a longer procedure time (32 (12–61) min vs. 23.5 (17–68) min vs. 25.0 (14–60) min; P = 0.001). The need for ML during the procedure was 4 (12.9%) in the EST group, 10 (10.4%) in the EPLBD group and 2 (3.4%) in the limited EST-EPLBD group. Post-procedure bleeding in the EST group was more common than that in the limited EST-EPLBD group (9.7% vs. 0%; P = 0.038). Furthermore, dilated bile duct was the only risk factor for bile duct stone recurrence in the limited EST-EPLBD group. Conclusions Limited EST-EPLBD exhibits a higher success rate but requires marginally longer procedure time for the first-session treatment. Furthermore, dilated bile duct is the only risk factor for bile duct stone recurrence in patients undergoing limited EST-EPLBD.

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Section: Introductionmentioning

confidence: 99%

The efficacy of limited endoscopic sphincterotomy plus endoscopic papillary large balloon dilation for removal of large bile duct stones

et al. 2019

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“…abnormalities of the biliary system, type of ESWL machine used, and body mass index (BMI). 7,8,12 In this study, BMI was found to be a factor related to the effectiveness of ESWL or total clearance in ESWL after biliary stent placement. This study obtained similar result to the study conducted by Frank et al in 2014, which examined the total clearance in 73 difficult stone subjects who underwent ESWL procedure.…”

Section: Discussionmentioning

confidence: 64%

Effectivity of Extracorporeal Shock Wave Lithotripsy and Stenting vs Stenting Only for Difficult Common Biliary Duct Stones: A Retrospective Analysis

Maulahela

Rumagesan

Abdullah

et al. 2023

InaJGHE

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Background: This study is conducted to investigate the effectiveness of extracorporeal shockwave lithotripsy (ESWL) after biliary stent placement compared to biliary stent placement alone in difficult common bile duct stones.Method: This is a retrospective cohort study using medical record data from the Gastrointestinal Endoscopy Center Registry of Dr. Cipto Mangunkusumo General National Hospital. We retrospectively evaluated 126 subjects with difficult bile stones. The subjects were divided into two groups: subjects subjected to biliary stent placement only and subjects who underwent ESWL procedure after the biliary stent placement. The effectiveness of the procedures was measured in the form of total clearance of bile stones.Results: A total of 126 subjects were included in this study, including 72 subjects who underwent ESWL procedure after biliary stent placement and 54 subjects who underwent biliary stent placement only. The effectiveness of ESWL after biliary stent placement in achieving total clearance was 69.1%, and the effectiveness of biliary stent placement in achieving total clearance was 64.8%. The ESWL procedure as adjuvant therapy after biliary stent placement did not provide a statistically significant difference (p = 0.703; 95% CI: 0.816–1.351). Normal body mass index was a factor that influences the effectiveness of ESWL after biliary stent placement (p = 0.002).Conclusion: The ESWL procedure as adjuvant therapy after biliary stent placement has the same level of effectiveness as biliary stent placement alone.

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“…In general, approximately 5-15% of bile duct stones failed to be detached with a single technique of sphincterotomy or EPBD, especially multiple and large CBDSs. Moreover, large common bile duct stone removal might need the concomitant use of EML, which is associated with severe procedure-related complications [9]. EPLBD uses a larger balloon size (12-20 mm) after limited EST is used as an alternative technique for removal of bile duct stones.…”

Section: Discussionmentioning

confidence: 99%

Combined endoscopic large balloon dilation with limited sphincterotomy versus sole sphincterotomy for removal of large or multiple common bile duct stones

Mohammed

Nada

Alabbasy

et al. 2023

Egypt Liver Journal

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Background Endoscopic papillary large balloon dilation (EPLBD) after sphincterotomy (EST) was introduced for the removal of large (≥ 10 mm) or multiple bile duct stones. This method combines the advantages of EST and EPLBD by increasing the efficacy of stone extraction while minimizing complications of EST and EPLBD when used alone. This prospective study aimed to compare between EPLBD with prior limited EST and sole sphnicterotomy for extraction of multiple and/or large common bile duct stones. Results Statistical analysis revealed insignificant difference between the studied groups as regards the presence of periamullary diverticulum (23% vs. 19%, P > 0.05) and the use of mechanical lithotripsy (4% vs. 9%, P > 0.05). The rates of overall and initial stone clearance were not significantly different between both groups [94% vs. 90%), P > 0.05; and 84% vs. 78%, P > 0.05, respectively]. The procedure-related pancreatitis and bleeding in EST/EPLBD group were lower compared to EST group (3% vs. 5%, P > 0.05; and 2% vs. 6%, P > 0.05, respectively). None of the studied groups’ patients died or developed procedure-related perforation or cholangitis. Conclusion Endoscopic large balloon dilation with prior limited sphincterotomy is an effective and safe endoscopic technique for removing multiple and/or large CBDSs.

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

Cited by 10 publications

References 33 publications

The efficacy of limited endoscopic sphincterotomy plus endoscopic papillary large balloon dilation for removal of large bile duct stones

The efficacy of limited endoscopic sphincterotomy plus endoscopic papillary large balloon dilation for removal of large bile duct stones

Effectivity of Extracorporeal Shock Wave Lithotripsy and Stenting vs Stenting Only for Difficult Common Biliary Duct Stones: A Retrospective Analysis

Combined endoscopic large balloon dilation with limited sphincterotomy versus sole sphincterotomy for removal of large or multiple common bile duct stones

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