Choledocian Empierrements: What Are The Factors Of Failure Of Stone Extraction?

Aims To assess the rate of stone extraction failure during choledocian empierrements (CE) and the associated factors.

Methods We conducted a retrospective study [2013 - 2020], collecting patients who had had an endoscopic retrograde pancreatography ERCP for MBD stone. CE was defined by the presence of multiple calculations (more than 3). Patients with difficult or impossible MDB catheterization were excluded. A single varied then multi-varied study using binary logistic regression was carried out (p significant if <0.05).

Results One hundred and seventy-one ERCP were carried out. The average age of patients was 64 [18-98] and sex ratio M/F was 0.54. The indication for ERCP was represented by: residual lithiasis of the MBD in 54 % of the cases, sequential treatment in 18 % of the cases, acute biliary pancreatitis in 16 % of the cases and acute cholangitis in 11 % cases. The diagnosis of CE was made by per cholangiography in 11 % of the cases. Extraction failure was noted in 19 % of patients, 75 % of whom had a biliary stent inserted. Five percent of patients presented with acute pancreatitis as the main complication. In single study, factors related to stone extraction failure were; female gender (p = 0.04), severe acute cholangitis (p<(10^-4)), residual MBD lithiasis (p <(10^-4)) and acute biliary pancreatitis (p <(10^-4)). In multi-varied study, two factors have been identified; severe acute cholangitis (OR = 5) and acute biliary pancreatitis (OR = 3).

Conclusions In our series, the rate of stone extraction failure was 19 %. The factors associated with the extraction failure were severe cholangitis and acute biliary pancreatitis.

Citation Temani MK, Mahmoudi M, Laabidi S et al. eP321 CHOLEDOCIAN EMPIERREMENTS: WHAT ARE THE FACTORS OF FAILURE OF STONE EXTRACTION? Endoscopy 2021; 53: S202.

Publication History

Article published online:
19 March 2021