Application value of cholangiopancreatography system in ERCP for common bile duct stone removal

doi:10.3877/cma.j.issn.2095-3232.2026.04.012

Abstract

Abstract:

Objective

To evaluate the application of cholangiopancreatography system in endoscopic retrograde cholangiopancreatography (ERCP) for patients with common bile duct stones.

Methods

Clinical data of 70 patients with common bile duct stones admitted to the Third Affiliated Hospital of Sun Yat-sen University from January to December 2024 were analyzed retrospectively. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 45 patients were male and 25 female, aged from 25 to 88 years, with a median age of 57 years. All patients were divided into the ERCP group (ERCP group, n=35) and eyeMax cholangiopancreatography system-assisted ERCP group (eyeMax group, n=35). The incidence of postoperative complications and overall stone removal rate between two groups were compared by Chi-square test or Fisher's exact test. Operation time, cumulative radiation dose, air kerma (AK) and hospitalization expenses were compared by t-test.

Results

The operation time and cumulative AK of radiation dose in the eyeMax group were (82±36) min and (111±56) mGy, significantly higher than (36±15) min and (55±31) mGy in the ERCP group (t=6.903, 5.169; both P<0.001). The hospitalization expense in the eyeMax group was (3.5±0.7)×10⁴ yuan, significantly higher than (2.6±0.5)×10⁴ yuan in the ERCP group (t=6.136, P<0.001). The procedures were successfully completed in two groups. The difficult intubation rates in the eyeMax and ERCP groups were 14%(5/35) and 23%(8/35), with no statistical significance (χ²=0.850, P=0.356). The overall stone removal rates in the eyeMax and ERCP groups were 97%(34/35) and 86%(30/35), with no statistical significance (P=0.198). Subgroup analysis showed that the residual rate of multiple stones in the eyeMax group was 4%(1/23), significantly lower than 31%(5/16) in the ERCP group (P=0.033). The recurrence rates of common bile duct stones in the eyeMax and ERCP groups were 9%(5/35) and 14%(3/35), with no statistical significance (P=0.710). No severe complications such as perforation and severe pancreatitis occurred in two groups. In the eyeMax group, 4 patients developed mild pancreatitis, 3 cases of hyperamylasemia, 3 cases of cholangitis and 1 case of hemorrhage, and 3,2,4 and 0 in the ERCP group, with no statistical significance (all P>0.05).

Conclusions

The cholangiopancreatography system-assisted ERCP can improve the removal rate of multiple common bile duct stones. This system enhances the visualization and precision of ERCP procedures without increasing the risk of severe complications. However, extensive attention should be paid to the radiation exposure, equipment cost and technical issues.

Key words: Common bile duct stones, EyeMax biliary and pancreatic imaging system, Endoscopic retrograde cholangiopancreatography(ERCP)

Lingjun Chen, Xiaoqin Wu, Li Tao, Fengping Zheng, Xianyi Lin. Application value of cholangiopancreatography system in ERCP for common bile duct stone removal[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2026, 15(04): 583-590.

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Figures/Tables 5

指标	eyeMax组	ERCP组	统计值	P值
性别(例, 男/女)	22/13	23/12	χ²=0.062	0.803
年龄(岁, $x ¯$ ±s)	60±15	55±14	t=1.253	0.214
合并高血压(例)	7	5	χ²=0.402	0.526
合并糖尿病(例)	8	4	χ²=1.609	0.205
合并胆囊结石(例)	16	20	χ²=0.915	0.339
WBC(×10⁹/L, $x ¯$ ±s)	7.2±3.6	6.8±2.4	t=0.446	0.657
Hb(g/L, $x ¯$ ±s)	115±18	127±23	t=-2.447	0.017
Plt(×10⁹/L, $x ¯$ ±s)	243±86	217±85	t=1.300	0.198
ALT [U/L, M(Q₁, Q₃)]	52(35, 139)	76(27, 113)	Z=-0.024	0.981
AST [U/L, M(Q₁, Q₃)]	47(34, 81)	49(25, 114)	Z=-0.476	0.634
TB [μmol/L, M(Q₁, Q₃)]	33(12, 89)	29(18, 104)	Z=0.241	0.810
DB [μmol/L, M(Q₁, Q₃)]	17(4, 55)	17(6, 67)	Z=-0.317	0.751
胆总管直径(mm, $x ¯$ ±s)	10±4	9±3	t=1.128	0.263
结石最大直径(mm, $x ¯$ ±s)	10±6	8±4	t=1.569	0.121
单发结石(例)	12	19	χ²=2.837	0.092

指标	eyeMax组	ERCP组	统计值	P值
性别(例, 男/女)	22/13	23/12	χ²=0.062	0.803
年龄(岁, $x ¯$ ±s)	60±15	55±14	t=1.253	0.214
合并高血压(例)	7	5	χ²=0.402	0.526
合并糖尿病(例)	8	4	χ²=1.609	0.205
合并胆囊结石(例)	16	20	χ²=0.915	0.339
WBC(×10⁹/L, $x ¯$ ±s)	7.2±3.6	6.8±2.4	t=0.446	0.657
Hb(g/L, $x ¯$ ±s)	115±18	127±23	t=-2.447	0.017
Plt(×10⁹/L, $x ¯$ ±s)	243±86	217±85	t=1.300	0.198
ALT [U/L, M(Q₁, Q₃)]	52(35, 139)	76(27, 113)	Z=-0.024	0.981
AST [U/L, M(Q₁, Q₃)]	47(34, 81)	49(25, 114)	Z=-0.476	0.634
TB [μmol/L, M(Q₁, Q₃)]	33(12, 89)	29(18, 104)	Z=0.241	0.810
DB [μmol/L, M(Q₁, Q₃)]	17(4, 55)	17(6, 67)	Z=-0.317	0.751
胆总管直径(mm, $x ¯$ ±s)	10±4	9±3	t=1.128	0.263
结石最大直径(mm, $x ¯$ ±s)	10±6	8±4	t=1.569	0.121
单发结石(例)	12	19	χ²=2.837	0.092

指标	eyeMax组	ERCP组	统计值	P值
操作成功 [例(%)]	35(100)	35(100)	/	/
困难插管 [例(%)]	5(14)	8(23)	χ²=0.850	0.356
结石清除 [例(%)]	34(97)	30(86)	-	0.198
多发结石残留 [例(%)]	1(4)	5 (31)	-	0.033
结石复发[例(%)]	5(14)	3(9)	-	0.710
取石操作时间(min, $x ¯$ ±s)	82±36	36±15	t=6.903	<0.001
累积AK值(mGy, $x ¯$ ±s)	111±56	55±31	t=5.169	<0.001
住院时间(d, $x ¯$ ±s)	7.3±2.9	6.5±1.9	t=1.379	0.173
住院费用(万元, $x ¯$ ±s)	3.5±0.7	2.6±0.5	t=6.136	<0.001
结石残留二次手术（例）	0	5	/	/
再次手术住院费用[万元, M(Q₁, Q₃)]	0	2.6(1.6, 3.5)	/	/

指标	eyeMax组	ERCP组	统计值	P值
操作成功 [例(%)]	35(100)	35(100)	/	/
困难插管 [例(%)]	5(14)	8(23)	χ²=0.850	0.356
结石清除 [例(%)]	34(97)	30(86)	-	0.198
多发结石残留 [例(%)]	1(4)	5 (31)	-	0.033
结石复发[例(%)]	5(14)	3(9)	-	0.710
取石操作时间(min, $x ¯$ ±s)	82±36	36±15	t=6.903	<0.001
累积AK值(mGy, $x ¯$ ±s)	111±56	55±31	t=5.169	<0.001
住院时间(d, $x ¯$ ±s)	7.3±2.9	6.5±1.9	t=1.379	0.173
住院费用(万元, $x ¯$ ±s)	3.5±0.7	2.6±0.5	t=6.136	<0.001
结石残留二次手术（例）	0	5	/	/
再次手术住院费用[万元, M(Q₁, Q₃)]	0	2.6(1.6, 3.5)	/	/

组别	例数	轻度胰腺炎	高淀粉酶血症	胆管炎	出血
eyeMax组	35	4(11)	3(9)	3(9)	1(3)
ERCP组	35	3(9)	2(6)	4(11)	0
P值^a		>0.999	>0.999	>0.999	>0.999

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