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DOI: 10.1055/s-0044-1788724
Is Endoscopic Retrograde Cholangiopancreatography with Balloon Sweeps a Must in Postcholecystectomy Stent Removal for Choledocholithiasis?
Funding None declared.Abstract
Objectives This study aims to evaluate whether stent removal through endoscopic retrograde cholangiopancreatography (ERCP) with balloon sweeps is necessary or whether stent removal by forward-viewing gastroscope without cholangiogram is sufficient.
Materials and Methods A prospective, single-center study was conducted from April 2022 to March 2023 for 1 year. Adult patients with choledocholithiasis who underwent common bile duct (CBD) clearance and CBD stenting followed by cholecystectomy were included. Then, they underwent CBD stent removal either by gastroscope directly or by side-viewing endoscopy with balloon sweeps and occlusion cholangiogram. Recurrence of stones and complications after stent removal were studied in both groups.
Results Forty-seven patients were enrolled in the final study. A total of 64% of patients (n = 30) underwent CBD stent removal followed by balloon sweeps and cholangiogram, and the remaining 34% (n = 17) patients underwent direct stent removal. Time taken for the procedure was more in the balloon sweeps group compared with the direct stent removal group and was statistically significant. No statistically significant adverse events were seen in both groups.
Conclusion Patients who underwent CBD stenting for choledocholithiasis after cholecystectomy can safely undergo stent removal using a gastroscope rather than be subjected again to ERCP. This will significantly reduce the duration, unplanned adverse events, and cost of ERCP.
Keywords
Choledocholiathiasis - Cholecystectomy - Endoscopic retrograde cholangiopancreaticography - GastroscopeAuthor Contributions
Conceptualization: D.S., M.I., S.L.; formal analysis: D.S., S.L., C.T., V.R., M.S.; project administration: D.S.; writing—original draft: D.S., S.L., C.T., V.B.; writing—review and editing: D.S., K.B., M.S., S.C., Y.L.
Ethics Committee Approval
The study was approved by the Institutional Ethics Committee Board at Lokmanya Tilak Municipal Medical College, Sion Hospital, Mumbai, India.
Publikationsverlauf
Artikel online veröffentlicht:
02. September 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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