Clinical features and outcomes of endoscopic treatment for stones in stemware-shaped common bile ducts: A multicenter data analysis

Jee Young Han, Don Haeng Lee, Seok Jeong, Hyun Jong Choi, Jong Ho Moon, Joung Ho Han, Chang Il Kwon, Tae Hoon Lee, Jong Jin Hyun, Jae Chul Hwang, Dong Hee Koh

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background/Aims: Various anatomical features of the biliary tree affect ability to remove difficult common bile duct (CBD) stones. In this study, we evaluated the clinical characteristics and outcomes of the endoscopic treatment of stones in stemware-shaped CBDs. Methods: Thirty-four patients with a stone and a stemware-shaped CBD who were treated at different tertiary referral centers from January 2008 to December 2012 were studied retrospectively. When stone removal failed, percutaneous or direct peroral cholangioscopic lithotripsy, endoscopic retrograde biliary drainage, or surgery was performed as a second-line procedure. Results: The overall success rate of the first-line procedure was 41.2%. Five of the 34 patients (14.7%) experienced procedure-related complications. No procedure-related mortality occurred. Mechanical lithotripsy was required to completely remove stones in 13 patients (38.2%). Conversion to a second-line procedure was required in 20 patients (58.8%). Mechanical lithotripsy was needed in 75% and 66.7% of those with a stone size of <1 cm or ≥1 cm, respectively. Stone recurrence occurred in two patients (9.1%) after 6 months and 27 months, respectively. Conclusions: The endoscopic treatment of stones in a stemware-shaped CBD is challenging. The careful assess-ment of difficult CBD stones is required before endoscopic procedures.

Original languageEnglish
Pages (from-to)800-804
Number of pages5
JournalGut and liver
Volume9
Issue number6
DOIs
Publication statusPublished - 2015 Nov

Keywords

  • Cholangiopancreatography, endoscopic retrograde
  • Choledocholithiasis
  • Common bile duct
  • Mechanical lithotripsy

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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    Han, J. Y., Lee, D. H., Jeong, S., Choi, H. J., Moon, J. H., Han, J. H., Kwon, C. I., Lee, T. H., Hyun, J. J., Hwang, J. C., & Koh, D. H. (2015). Clinical features and outcomes of endoscopic treatment for stones in stemware-shaped common bile ducts: A multicenter data analysis. Gut and liver, 9(6), 800-804. https://doi.org/10.5009/gnl14433