Application of ERCP in treatment of common bile duct stones after cholecystectomy

doi:10.3877/cma.j.issn.2095-3232.2021.05.015

Abstract

Abstract:

Objective

To evaluate the application value of endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of common bile duct stones after cholecystectomy.

Methods

Clinical data of 76 patients with common bile duct stones after cholecystectomy who received initial ERCP in the Third Affiliated Hospital of Sun Yat-sen University from January 2011 to April 2021 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 46 patients were male and 30 female, aged (61±13) years on average. ERCP treatment, complications and clinical effects were observed.

Results

ERCP in all 74 patients were completed successfully, whereas stone removal failed in 2 cases. The success rate of stone removal was 97%(74/76). The operation time was (98±60) min. The length of postoperative hospital stay was 2-18 d, witha median 5 d. Postoperative complications occurred in 6 cases with an incidence rate of 8%(6/76). Among them, 2 cases developed mild pancreatitis and 4 cases of infection, and all were cured after conservative treatments. 5 patients presented with postoperative recurrence of stones and received repeated ERCP treatment. The stone recurrence rate was 7%(5/74).

Conclusions

ERCP is a minimally invasive, safe and effective method for patients with common bile duct stones after cholecystectomy, which can be considered as the primary option of non-surgical treatments.

Key words: Choledocholithiasis, Cholecystectomy, Cholangiopancreatography, endoscopic retrograde, Treatment

Ying Lin, Xianyi Lin, Rong Chen, Xuemei Pan. Application of ERCP in treatment of common bile duct stones after cholecystectomy[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2021, 10(05): 502-505.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhgzwkssxdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-3232.2021.05.015

https://zhgzwkssxdzzz.cma-cmc.com.cn/EN/Y2021/V10/I05/502

References 20

[1]	Dasari BV,，Tan CJ,，Gurusamy KS，et al．Surgical versus endoscopic treatment of bile duct stones[J]．Cochrane Database Syst Rev, 2013(12):CD003327．
[2]	卢绮萍. 关注胆囊结石病治疗策略的争议、共识与发展[J]. 腹部外科, 2017, 30(5):334-337.
[3]	中华医学会外科学分会胆道外科学组. 胆囊良性疾病治疗决策的专家共识(2011版)[J]. 中华消化外科杂志, 2011, 10(1): 14-19.
[4]	杜开放, 吕文才, 邹运, 等. 胆囊切除术后原发性胆总管结石的研究现状[J]. 肝胆胰外科杂志, 2019, 31(2):122-124,封3.
[5]	Martin DJ,，Vernon D,，Toouli J. Surgical versus endoscopic treatment of bile duct stones[J]. Coehrane Database Syst Rev, 2006, 19(2): CD003327．
[6]	王怀志，苑军正，汪海，等. 腹腔镜胆囊切除术后残余胆管结石原因分析及处理[J/CD]. 中华普外科手术学杂志(电子版), 2016，10(2):179-180．
[7]	Choi YS, Do JH, Suh SW, et al. Risk factors for the late development of common bile duct stones after laparoscopic cholecystectomy[J]. Surg Endosc, 2017, 31(11):4857-4862.
[8]	中华医学会外科学分会胆道外科学组, 中国医师协会外科医师分会胆道外科医师委员会. 胆囊切除术后常见并发症的诊断与治疗专家共识(2018版)[J]. 中华消化外科杂志, 2018, 17(4):325-328.
[9]	奚士航, 王小明, 季月辉, 等. LCBDE与ERCP/EST治疗胆囊切除术后胆总管结石的疗效对比[J]. 齐齐哈尔医学院学报, 2018, 39(21):2489-2491.
[10]	李富国. ERCP在胆囊切除术后胆总管结石诊断与治疗中的价值评价[J]. 北方药学, 2011, 8(4):52-53, 10.
[11]	宋敏, 黄晓东, 王萍, 等. 不同方法对胆囊切除术后胆总管结石患者的诊疗评价[J]. 临床消化病杂志, 2008, 20(1):50-52.
[12]	Freeman ML. Understanding risk factors and avoiding complications with endoscopic retrograde cholangiopancreatography[J]. Curt Gastroenterol Rep, 2003, 5(2):145-153．
[13]	蔡宇, 何彦安. 胆囊结石合并胆总管结石患者行腹腔镜胆囊切除联合胆总管切开取石T管引流术后结石复发危险因素分析[J]. 肝胆外科杂志, 2016, 24(3):203-205.
[14]	高登有, 宗德宝, 刘鹏飞. 腹腔镜胆道探查术与ERCP治疗胆囊切除术后胆总管结石的效果及复发率比较[J]. 临床医学研究与实践, 2019, 4(9):89-91.
[15]	Liu J, Jin L, Zhang Z. Laparoscopic transcystic treatment biliary calculi by laser lithotripsy[J]. JSLS, 2016, 20(4):e2016.00068.
[16]	徐晓欧. 取石球囊和网篮在内镜治疗肝外胆道结石中的临床应用[D]. 沈阳: 中国医科大学, 2014.
[17]	于剑锋, 郝建宇, 吴东方, 等. 经内镜胆道内支架放置术和鼻胆管引流术治疗各级急性胆管炎的效果比较[J]. 中华消化内镜杂志, 2019, 36(3):169-175.
[18]	吴丽颖, 王书海, 贾国法, 等. 经十二指肠镜乳头括约肌切开取石术后胆总管结石复发危险因素分析[J/CD]. 中华消化病与影像杂志(电子版), 2015, 5(1):5-9．
[19]	Konsten J, Gouma DJ, von Meyenfeldt MF, et al. Long-term follow-up after open cholecystectomy[J]. Br J Surg, 1993, 80(1):100-102.
[20]	Chen CM, Tay KH, Hoe MN, et a1. Endoscopic retrograde cholangiopancreatography management of common bile duct stones in asurgical unit[J]. ANZ J Surg, 2005, 75(12):1070-1072．

Please choose a citation manager

Content to export