Therapeutic Endoscopic Interventions in Choledocholithiasis: Efficacy of Endoscopic Retrograde...

Choledocholithiasis, a condition characterized by stones in the common bile duct (CBD), frequently results in obstructive jaundice and associated complications. Endoscopic retrograde cholangiopancreatography (ERCP) has emerged as the gold standard for treating this condition, offering a minimally invasive therapeutic approach. However, while ERCP is widely used, its efficacy in managing diverse clinical presentations and potential complications necessitates further investigation. Additionally, data on ERCP's effectiveness in various clinical scenarios, particularly concerning stone size and location, remain inconsistent, highlighting the need for more comprehensive research in this area.

This study aims to evaluate the effectiveness of ERCP as a therapeutic intervention for choledocholithiasis, focusing on procedural outcomes, stone clearance rates, and associated complications.

A retrospective study was conducted on 50 patients diagnosed with choledocholithiasis who underwent ERCP at a tertiary care hospital between January 2022 and December 2023. Data on patient demographics, clinical presentation, imaging, laboratory findings, and procedural outcomes were collected. ERCP procedures, including endoscopic sphincterotomy (ES) with balloon extraction and stenting, were performed by experienced endoscopists. Statistical analysis was done using SPSS version 25.

The majority of patients were aged 31-70 years, with abdominal pain (96%) being the most common symptom. ERCP successfully cleared the CBD in 76% of cases in a single session, with repeat ERCP required for 18% of patients. Complications occurred in 20% of cases, with pancreatitis (10%) being the most common. Smaller stones (≤10 mm) had higher success rates for single-session clearance, while larger stones (>15 mm) often required repeat procedures or surgery. Distal CBD stones were cleared more effectively compared to those in proximal locations.

ERCP remains an effective and safe treatment for choledocholithiasis, particularly for smaller and distal CBD stones. The procedure's safety and efficacy support its continued use as the gold standard for managing choledocholithiasis.