Uncomplicated common bile duct stone removal guided by cholangioscopy versus conventional endoscopic retrograde cholangiopancreatography

Ridtitid, Wiriyaporn; Luangsukrerk, Thanawat; Angsuwatcharakon, Phonthep; Piyachaturawat, Panida; Aumpansub, Prapimphan; Hurst, Cameron; Chaiteerakij, Roongruedee; Kongkam, Pradermchai; Rerknimitr, Rungsun

doi:10.1007/s00464-017-5966-2

Cited by 16 publications

(52 citation statements)

References 22 publications

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“…Ducts were completely cleared (technical success) in 97.3% of patients and cleared in a single session in 77.4% of patients . The results corroborate previously published studies on D‐SOC in the management of difficult‐to‐treat bile duct stones . The overall success rate of stone removal with D‐SOC appears to be over 95%.…”

Section: Therapeutic Cholangioscopic Proceduressupporting

confidence: 84%

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Biliary interventions using single‐operator cholangioscopy

Navaneethan

Moon²,

Itoi

2019

Digestive Endoscopy

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Cholangioscopy provides an opportunity to directly visualize the bile duct for diagnosing biliary lesions and for therapeutic interventions. Although there are different cholangioscopy techniques available, single‐operator cholangioscopy has gained widespread acceptance as the standard technique for interventions in the biliary system because of its ease of use and widespread availability. Single‐operator cholangioscopy can be used for both diagnostic and therapeutic indications in the biliary tract. Diagnostic cholangioscopy is used for direct evaluation of indeterminate bile duct strictures with biopsies, diagnosing filling defects in the bile ducts observed during endoscopic retrograde cholangiography (ERC) imaging, preoperative mapping of the precise location and extension of tumors of the biliary tract, and diagnosis of intraductal neoplasms. Therapeutic cholangioscopy is used for visually guided treatment of biliary stones that have failed extraction with conventional ERC techniques, residual or impacted stones by using intraductal lithotripsy, ablation of biliary tumors and for facilitation of guidewire advancement into selective intrahepatic ducts for adequate biliary drainage. In this review, we will focus on advances in the single‐operator cholangioscopy techniques in the diagnosis and management of biliary disorders.

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Section: Therapeutic Cholangioscopic Proceduressupporting

confidence: 84%

“…36 The results corroborate previously published studies on D-SOC in the management of difficult-to-treat bile duct stones. 6,22,33,[36][37][38][39][40][41] The overall success rate of stone removal with D-SOC appears to be over 95%.…”

Section: Intraductal Lithotripsy For Difficult Bile Duct Stonesmentioning

confidence: 99%

Biliary interventions using single‐operator cholangioscopy

Navaneethan

Moon²,

Itoi

2019

Digestive Endoscopy

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“…Consequently, a basket stone extraction was performed instead of planned laser lithotripsy. The mean time of biliary exploration and whole NR-ERCP were 8.60 ± 1.96 (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) and 32.96 ± 16.29 (13-82) minutes, respectively. Setting 10 mm as a cut-off value, 27 and 26 patients were with a dilated and a non-dilated CBD.…”

Section: Comparison Of Technical Details and Outcomes Between Two Modmentioning

confidence: 99%

“…Using a non-radiation strategy may be an alternative for controlling and minimizing in-procedure radiation. To avoid potential radiation caused health consequences, there has been interest in the use of non-radiation ERCP (NR-ERCP) in recent years [7][8][9][10]. There are two major techniques of NR-ERCP, namely endoscopic ultrasound assisted [7,8] and digital cholangioscopy (DCS)-assisted [9,10] ERCP.…”

Section: Introductionmentioning

confidence: 99%

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Application of digital cholangioscopy assisted non-radiation endoscopic retrieval of common bile duct stones

Feng¹,

Xu²,

Liu³

et al. 2020

Preprint

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Background Few studies have evaluated digital cholangioscopy (DCS) assisted non-radiation endoscopic retrograde cholangiopancreatography (NR-ERCP) for choledocholithiasis. Here, we evaluated the application of DCS assisted NR-ERCP for endoscopic retrieval of common bile duct (CBD) stones.Methods Patients who underwent ERCP for choledocholithiasis and without prior ERCP were included. Data related to technical success and outcomes of DCS-assisted NR-ERCP and conventional ERCP were retrieved and compared. Procedure and technical details of DCS assisted NR-ERCP were collated and reviewed.Results In total, 304 and 53 patients who underwent conventional and DCS-assisted ERCP were recruited. Relatively larger stones (p < 0.001) was present in DCS assisted NR-ERCP. No statistical difference was present in biliary access, lithotripsy, stone removal and total complications. A higher proportion of larger balloon for EPBD (p < 0.001) and more ERCP sessions for stone clearance (p < 0.001) were present in conventional ERCP. In DCS-assisted ERCP, technical success was achieved in 52 (98.1%) patients and DCS-guided laser lithotripsy was applied in 9 (17%) patients. DCS guided laser lithotripsy was superior to mechanical lithotripsy for stone clearance (p < 0.001) in large stones. Mean length of biliary exploration and whole NR-ERCP were 8.60 ± 1.96 (6–19) and 32.96 ± 16.29 (13–82) minutes, respectively. One delayed bile-leakage, one moderate pancreatitis, two mild pancreatitis and five cases of hyperamylasemia occurred. Technical details and complications were not statistically differed between patients with a dilated and a non-dilated CBD.Conclusions DCS-based NR-ERCP is technically feasible and safe for retrieval of CBD stones. It provides an alternative to conventional ERCP for endoscopic treatment of simple choledocholithiasis.

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Endoscopic clearance of non‐complex biliary stones using fluoroscopy‐free direct solitary cholangioscopy: Initial multicenter experience

et al. 2023

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Background and AimsFluoroscopy‐free endoscopic retrograde cholangiopancreatography for common bile duct stone (CBDS) clearance is usually offered only to pregnant patients. We initiated a multicenter, randomized controlled trial comparing clearance of non‐complex CBDSs using fluoroscopy‐free direct solitary cholangioscopy (DSC) to standard endoscopic retrograde cholangiography (ERC) to evaluate the wider applicability of the DSC‐based approach. Here we report the initial results of stone clearance and safety in roll‐in cases for the randomized controlled trial.MethodsTwelve expert endoscopists at tertiary care centers in four countries prospectively enrolled 47 patients with non‐complex CBDSs for DSC‐assisted CBDS removal in an index procedure including fluoroscopy‐free cannulation. Successful CBDS clearance was first determined by DSC and subsequently validated by final occlusion cholangiogram as the ERC gold standard.ResultsFully fluoroscopy‐free cannulation was successful in 42/47 (89.4%) patients. Brief fluoroscopy with minimal contrast injection was used in 4/47 (8.5%) patients during cannulation. Cannulation failed in 1/47 (2.1%) patients. Fluoroscopy‐free complete stone clearance was reached in 38/46 (82.6%) cases. Residual stones were detected in the validation ERC occlusion cholangiogram in three cases. Overall serious adverse event rate was 2.1% (95% confidence interval 0.1–11.3): postprocedural pancreatitis in one patient.ConclusionsIn patients with non‐complex CBDS, the fluoroscopy‐free technique is easily transferred to endoscopic retrograde cholangiopancreatography experts with acceptable rates of cannulation and stone clearance and few serious adverse events. (ClinicalTrials.gov number, NCT03421340)

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Uncomplicated common bile duct stone removal guided by cholangioscopy versus conventional endoscopic retrograde cholangiopancreatography

Cited by 16 publications

References 22 publications

Biliary interventions using single‐operator cholangioscopy

Biliary interventions using single‐operator cholangioscopy

Application of digital cholangioscopy assisted non-radiation endoscopic retrieval of common bile duct stones

Endoscopic clearance of non‐complex biliary stones using fluoroscopy‐free direct solitary cholangioscopy: Initial multicenter experience

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