Endoscopic treatment of choledocholithiasis

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Hepatobiliary Medicine

Background:

• Choledocholithiasis, or bile duct stones, is a common condition requiring effective treatment.
• Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic papillosphincterotomy (EPS) is a primary intervention.
• Understanding the outcomes and complications of EPS for choledocholithiasis is crucial for clinical practice.

Purpose of the Study:

• To evaluate the efficacy and safety of endoscopic papillosphincterotomy (EPS) for treating choledocholithiasis.
• To analyze the indications, success rates, and complication profiles of EPS in a large patient cohort.
• To report on the management of complications arising from EPS procedures.

Main Methods:

• Retrospective analysis of 363 successful endoscopic papillosphincterotomy (EPS) procedures.
• Data collection on patient demographics, indications for EPS, and gallbladder status.
• Documentation of stone removal success rates, complication types, and patient outcomes.

Main Results:

• Choledocholithiasis was the indication for EPS in 74.4% of cases (270 patients).
• Successful stone removal from the common bile duct was achieved in 95.5% of procedures.
• Overall complication rate was 4.7% (17 cases), including bleeding (1.9%) and perforation (1.1%), with a mortality of 1.1% (4 deaths).

Conclusions:

• Endoscopic papillosphincterotomy (EPS) is a highly effective treatment for choledocholithiasis with a high success rate for stone removal.
• While complications can occur, they are manageable, and EPS is a safe endoscopic intervention for bile duct stones.
• EPS is particularly valuable in patients post-cholecystectomy or when surgery is contraindicated.