Sagami R.a· Hayasaka K.b· Ujihara T.b· Iwaki T.c· Katsuyama Y.c· Harada H.c· Tsuji H.a· Sato T.a· Nishikiori H.a· Murakami K.d· Amano Y.c

Author affiliations

aDepartment of Gastroenterology, Oita San-ai Medical Center, Oita, Japan
bDepartment of Gastroenterology, New Tokyo Hospital, Matsudo, Japan
cDepartment of Gastroenterology, Urawa Kyosai Hospital, Saitama, Japan
dDepartment of Gastroenterology, Faculty of Medicine, Oita University, Yufu, Japan

Log in to MyKarger to check if you already have access to this content.

Buy FullText & PDF Unlimited re-access via MyKarger Unrestricted printing, no saving restrictions for personal use read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.

Save over 20% compared to the individual article price.

Learn more

Rent/Cloud Rent for 48h to view Buy Cloud Access for unlimited viewing via different devices Synchronizing in the ReadCube Cloud Printing and saving restrictions apply Rental: USD 8.50
Cloud: USD 20.00

Select

Subscribe Access to all articles of the subscribed year(s) guaranteed for 5 years Unlimited re-access via Subscriber Login or MyKarger Unrestricted printing, no saving restrictions for personal use read more

Subcription rates

Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview

Received: April 21, 2021
Accepted: January 08, 2022
Published online: February 04, 2022

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 3

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: https://www.karger.com/DIG

Abstract

Background/Aims: Residual common bile duct (CBD) stones occasionally become symptomatic after stone removal with endoscopic retrograde cholangiopancreatography (ERCP) upon removal of the endoscopic biliary stent (EBS). An accurate evaluation of residual stones before stent removal is necessary. This study evaluated a new two-step check method using endoscopic ultrasound (EUS) for the detection of residual stones after ERCP stone removal. Methods: Fifty-six patients who underwent CBD stone removal and EBS placement were prospectively enrolled. Residual stones were evaluated by the check method. EBS was removed at the time of the check method or at a later time of residual stone removal. The primary outcome was to evaluate the efficacy of this check method. Results: Residual CBD stone/sludge was detected in 20 of 56 patients (35.7%; stones: 28.6%, sludge: 7.1%) by the check method and removed by the ERCP procedure at a later time. After stent and final stone removal, patients were followed for an average of 211 days; cholangitis recurred in only 1.8% of patients. There were no adverse events associated with the check method. Temporary EBS prevented the recurrence of cholangitis by residual stone and caused no adverse events in the pancreatobiliary tract until the two-step check method (median, 113 days; range, 17–232 days). Conclusion: The new check method may be ideal and feasible for EBS removal because recurrences are very rare when a clear CBD has been verified, and an additional ERCP procedure is also possibly avoided.

© 2022 S. Karger AG, Basel

References Tsunoda K, Shirai Y, Hatakeyama K. Prevalence of cholesterol gallstones positively correlates with per capita daily calorie intake. Hepatogastroenterology. 2004 Sep–Oct;51(59):1271–4. Caddy GR, Tham TC. Gallstone disease: symptoms, diagnosis and endoscopic management of common bile duct stones. Best Pract Res Clin Gastroenterol. 2006;20(6):1085–101. Freitas ML, Bell RL, Duffy AJ. Choledocholithiasis: evolving standards for diagnosis and management. World J Gastroenterol. 2006 May 28;12(20):3162–7. Kiriyama S, Kozaka K, Takada T, Strasberg SM, Pitt HA, Gabata T, et al. Tokyo guidelines 2018: diagnostic criteria and severity grading of acute cholangitis (with videos). J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):17–30. Mukai S, Itoi T, Baron TH, Takada T, Strasberg SM, Pitt HA, et al. Indications and techniques of biliary drainage for acute cholangitis in updated Tokyo guidelines 2018. J Hepatobiliary Pancreat Sci. 2017 Oct;24(10):537–49. Eto K, Kawakami H, Haba S, Yamato H, Okuda T, Yane K, et al. Single-stage endoscopic treatment for mild to moderate acute cholangitis associated with choledocholithiasis: a multicenter, non-randomized, open-label and exploratory clinical trial. J Hepatobiliary Pancreat Sci. 2015 Dec;22(12):825–30. Ito T, Sai JK, Okubo H, Saito H, Ishii S, Kanazawa R, et al. Safety of immediate endoscopic sphincterotomy in acute suppurative cholangitis caused by choledocholithiasis. World J Gastrointest Endosc. 2016 Feb 10;8(3):180–5. Weinberg BM, Shindy W, Lo S. Endoscopic balloon sphincter dilation (sphincteroplasty) versus sphincterotomy for common bile duct stones. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD004890. Southern Surgeons Club. A prospective analysis of 1518 laparoscopic cholecystectomies. N Engl J Med. 1991 Apr 18;324(16):1073–8. Girometti R, Brondani G, Cereser L, Como G, Del Pin M, Bazzocchi M, et al. Post-cholecystectomy syndrome: spectrum of biliary findings at magnetic resonance cholangiopancreatography. Br J Radiol. 2010 Apr;83(988):351–61. Mohamadnejad M, Hashemi SJ, Zamani F, Baghai-Wadji M, Malekzadeh R, Eloubeidi MA. Utility of endoscopic ultrasound to diagnose remnant stones in symptomatic patients after cholecystectomy. Endoscopy. 2014 Aug;46(8):650–5. Netinatsunton N, Attasaranya S, Sottisuporn J, Witeerungrot T, Jongboonyanuparp T, Piratvisuth T, et al. Comparing cost-effectiveness between endoscopic ultrasound and endoscopic retrograde cholangiopancreatography in diagnosis of common bile duct stone in patients with predefined risks: a study from a developing country. Endosc Ultrasound. 2016 May–Jun;5(3):165–72. Schirmer BD, Winters KL, Edlich RF. Cholelithiasis and cholecystitis. J Long Term Eff Med Implants. 2005;15(3):329–38. Riciardi R, Islam S, Canete JJ, Arcand PL, Stoker ME. Effectiveness and long-term results of laparoscopic common bile duct exploration. Surg Endosc. 2003 Jan;17(1):19–22. Metcalfe MS, Ong T, Bruening MH, Iswariah H, Wemyss-Holden SA, Maddern GJ. Is laparoscopic intraoperative cholangiogram a matter of routine? Am J Surg. 2004 Apr;187(4):475–81. Frossard JL, Hadengue A, Amouyal G, Choury A, Marty O, Giostra E, et al. Choledocholithiasis: a prospective study of spontaneous common bile duct stone migration. Gastrointest Endosc. 2000 Feb;51(2):175–9. Tse F, Liu L, Barkun AN, Armstrong D, Moayyedi P. EUS: a meta-analysis of test performance in suspected choledocholithiasis. Gastrointest Endosc. 2008 Feb;67(2):235–44. Aljebreen A, Azzam N, Eloubeidi MA. Prospective study of endoscopic ultrasound performance in suspected choledocholithiasis. J Gastroenterol Hepatol. 2008 May;23(5):741–5. Scheiman JM, Carlos RC, Barnett JL, Elta GH, Nostrant TT, Chey WD, et al. Can endoscopic ultrasound or magnetic resonance cholangiopancreatography replace ERCP in patients with suspected biliary disease? A prospective trial and cost analysis. Am J Gastroenterol. 2001 Oct;96(10):2900–4. Prat F, Amouyal G, Amouyal P, Pelletier G, Fritsch J, Choury AD, et al. Prospective controlled study of endoscopic ultrasonography and endoscopic retrograde cholangiography in patients with suspected common-bileduct lithiasis. Lancet. 1996 Jan 13;347(8994):75–9. Canto MI, Chak A, Stellato T, Sivak MV Jr. Endoscopic ultrasonography versus cholangiography for the diagnosis of choledocholithiasis. Gastrointest Endosc. 1998 Jun;47(6):439–48. Buscarini E, Tansini P, Vallisa D, Zambelli A, Buscarini L. EUS for suspected choledocholithiasis: do benefits outweigh costs? A prospective, controlled study. Gastrointest Endosc. 2003 Apr;57(4):510–8. Liu TH, Consorti ET, Kawashima A, Tamm EP, Kwong KL, Gill BS, et al. Patient evaluation and management with selective use of magnetic resonance cholangiography and endoscopic retrograde cholangiopancreatography before laparoscopic cholecystectomy. Ann Surg. 2001 Jul;234(1):33–40. Cabada Giadás T, Sarría Octavio de Toledo L, Martínez-Berganza Asensio MT, Cozcolluela Cabrejas R, Alberdi Ibáñez I, Alvarez López A, et al. Helical CT cholangiography in the evaluation of the biliary tract: application to the diagnosis of choledocholithiasis. Abdom Imaging. 2002 Jan–Feb;27(1):61–70. Hallal AH, Amortegui JD, Jeroukhimov IM, Casillas J, Schulman CI, Manning RJ, et al. Magnetic resonance cholangiopancreatography accurately detects common bile duct stones in resolving gallstone pancreatitis. J Am Coll Surg. 2005 Jun;200(6):869–75. Kondo S, Isayama H, Akahane M, Toda N, Sasahira N, Nakai Y, et al. Detection of common bile duct stones: comparison between endoscopic ultrasonography, magnetic resonance cholangiography, and helical-computed-tomographic cholangiography. Eur J Radiol. 2005 May;54(2):271–5. Freeman ML, Guda NM. ERCP cannulation: a review of reported techniques. Gastrointest Endosc. 2005 Jan;61(1):112–25. Shim CS, Joo JH, Park CW, Kim YS, Lee JS, Lee MS, et al. Effectiveness of endoscopic ultrasonography in the diagnosis of choledocholithiasis prior to laparoscopic cholecystectomy. Endoscopy. 1995 Aug;27(6):428–32. Article / Publication Details

First-Page Preview

Received: April 21, 2021
Accepted: January 08, 2022
Published online: February 04, 2022

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 3

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: https://www.karger.com/DIG

Copyright / Drug Dosage / Disclaimer Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.