Endoscopic Management of Common Bile Duct Stones Leaving the Gallbladder in situ

2004 ◽  
Vol 21 (1) ◽  
pp. 60-65 ◽  
Author(s):  
W.H. Schreurs ◽  
W.J. Vles ◽  
W.H.N.M. Stuifbergen ◽  
H.J.M. Oostvogel
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stones ◽  
Endoscopic Management ◽  
Bile Duct Stones ◽  
Gallbladder In Situ

scholarly journals Cholecystectomy outcomes after endoscopic sphincterotomy in patients with choledocholithiasis: A meta-analysis

2020 ◽  
Author(s):  
Jie Xu ◽  
Chuang Yang
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Sphincterotomy ◽  
Common Bile Duct Stones ◽  
Bile Duct Stones ◽  
Recurrent Pancreatitis ◽  
Significant Difference ◽  
Risk Patients ◽  
Gallbladder In Situ

Abstract Background Endoscopic sphincterotomy is the standard treatment for common bile duct stones.There is different evidence considering complications specifically biliary pancreatitis and cholangitis with the use of cholecystectomy after endoscopic sphincterotomy.The purpose of this article is to compare the positive cholecystectomy after endoscopic treatment of common bile duct stones, whether the incidence of recurrent pancreatitis cholangitis is reduced, especially in high-risk patients. Methods We searched Pubmed(1990-2019)、Embase(1990-2019)和 Cochrane(1990-2019)database for trials comparing the 2 strategies for gallstones after ES.A related article on the removal of gallbladder after endoscopic sphincterotomy was collected,followed by analysis of each group using RevMan. Results We have adopted a total of 8 studies, including 7 randomized controlled trials and 1 retrospective study. A total of 12718 patients were included in the study, 4922 in the early cholecystectomy group, and 7795 in the gallbladder in situ group.During the follow-up period, 41 patients had pancreatitis after endoscopic sphincterotomy in the cholecystectomy group, and 177 patients in the wait-and-see group. The incidence of pancreatitis in the gallbladder in situ group was significantly reduced(RR 0.38, 95%CI 0.27 to 0.53, P < 0.00001,I 2 =0%).The incidence of cholangitis and jaundice in the removal of the gallbladder group was also less than that in the preserved gallbladder group(RR 0.31, 95%CI 0.26 to 0.38, P < 0.00001,I 2 =0%).There was no significant difference in mortality between the two groups(RR 0.73, 95%CI 0.52 to 1.02, P =0.07,I 2 =14%).There is a significant difference in cholecystitis or biliary colic(RR 0.25, 95% CI 0.21 to 0.29, P < 0.00001,I 2 =28%). Conclusions Early endoscopic cholecystectomy after removal of common bile duct stones can effectively reduce biliary complications such as recurrent pancreatitis, cholangitis and cholecystitis. This is still true for high-risk patients, and has no significant effect on the mortality of patients. After ES,laparoscopic cholecystectomy should be recommended.

scholarly journals Cholecystectomy outcomes after endoscopic sphincterotomy in patients with choledocholithiasis: A meta-analysis

2020 ◽  
Author(s):  
Jie Xu ◽  
Chuang Yang
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Sphincterotomy ◽  
Common Bile Duct Stones ◽  
Bile Duct Stones ◽  
Recurrent Pancreatitis ◽  
Significant Difference ◽  
Risk Patients ◽  
Gallbladder In Situ

Abstract Background Endoscopic sphincterotomy is the standard treatment for common bile duct stones.There is different evidence considering complications specifically biliary pancreatitis and cholangitis with the use of cholecystectomy after endoscopic sphincterotomy.The purpose of this article is to compare the positive cholecystectomy after endoscopic treatment of common bile duct stones, whether the incidence of recurrent pancreatitis cholangitis is reduced, especially in high-risk patients. Methods We searched Pubmed(1990-2019)、Embase(1990-2019)和 Cochrane(1990-2019)database for trials comparing the 2 strategies for gallstones after ES.A related article on the removal of gallbladder after endoscopic sphincterotomy was collected,followed by analysis of each group using RevMan. Results We have adopted a total of 8 studies, including 7 randomized controlled trials and 1 retrospective study. A total of 12718 patients were included in the study, 4922 in the early cholecystectomy group, and 7795 in the gallbladder in situ group.During the follow-up period, 41 patients had pancreatitis after endoscopic sphincterotomy in the cholecystectomy group, and 177 patients in the wait-and-see group. The incidence of pancreatitis in the gallbladder in situ group was significantly reduced(RR 0.38, 95%CI 0.27 to 0.53, P < 0.00001,I 2 =0%).The incidence of cholangitis and jaundice in the removal of the gallbladder group was also less than that in the preserved gallbladder group(RR 0.31, 95%CI 0.26 to 0.38, P < 0.00001,I 2 =0%).There was no significant difference in mortality between the two groups(RR 0.73, 95%CI 0.52 to 1.02, P =0.07,I 2 =14%).There is a significant difference in cholecystitis or biliary colic(RR 0.25, 95% CI 0.21 to 0.29, P < 0.00001,I 2 =28%). Conclusions Early endoscopic cholecystectomy after removal of common bile duct stones can effectively reduce biliary complications such as recurrent pancreatitis, cholangitis and cholecystitis. This is still true for high-risk patients, and has no significant effect on the mortality of patients. After ES,laparoscopic cholecystectomy should be recommended.

scholarly journals Cholecystectomy outcomes after endoscopic sphincterotomy in patients with choledocholithiasis: A meta-analysis

2019 ◽  
Author(s):  
Jie Xu ◽  
Chuang Yang
Keyword(s):  
High Risk ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Sphincterotomy ◽  
Common Bile Duct Stones ◽  
Bile Duct Stones ◽  
Recurrent Pancreatitis ◽  
Significant Difference ◽  
Gallbladder In Situ

Abstract Background Endoscopic sphincterotomy is the standard treatment for common bile duct stones.There is different evidence considering complications specifically biliary pancreatitis and cholangitis with the use of cholecystectomy after endoscopic sphincterotomy.The purpose of this article is to compare the positive cholecystectomy after endoscopic treatment of common bile duct stones, whether the incidence of recurrent pancreatitis cholangitis is reduced, especially in high-risk patients.Methods We searched Pubmed(1990-2019)、Embase(1990-2019)和 Cochrane(1990-2019)database for trials comparing the 2 strategies for gallstones after ES.A related article on the removal of gallbladder after endoscopic sphincterotomy was collected,followed by analysis of each group using RevMan.Results We have adopted a total of 8 studies, including 7 randomized controlled trials and 1 retrospective study. A total of 12718 patients were included in the study, 4922 in the early cholecystectomy group, and 7795 in the gallbladder in situ group.During the follow-up period, 41 patients had pancreatitis after endoscopic sphincterotomy in the cholecystectomy group, and 177 patients in the wait-and-see group. The incidence of pancreatitis in the gallbladder in situ group was significantly reduced(RR 0.38, 95%CI 0.27 to 0.53, P < 0.00001,I 2 =0%).The incidence of cholangitis and jaundice in the removal of the gallbladder group was also less than that in the preserved gallbladder group(RR 0.31, 95%CI 0.26 to 0.38, P < 0.00001,I 2 =0%).There was no significant difference in mortality between the two groups(RR 0.73, 95%CI 0.52 to 1.02, P =0.07,I 2 =14%).There is a significant difference in cholecystitis or biliary colic(RR 0.25, 95% CI 0.21 to 0.29, P < 0.00001,I 2 =28%).Conclusions Early endoscopic cholecystectomy after removal of common bile duct stones can effectively reduce biliary complications such as recurrent pancreatitis, cholangitis and cholecystitis. This is still true for high-risk patients, and has no significant effect on the mortality of patients. After ES,laparoscopic cholecystectomy should be recommended.

Su1632 Cholecystectomy or Gallbladder in Situ After Endoscopic Clearance of Common Bile Duct Stones in Elderly Patients

2014 ◽  
Vol 79 (5) ◽  
pp. AB346-AB347
Author(s):  
Ji Woong Jang ◽  
Yongsoo Cho ◽  
Hyun Cheol Koo ◽  
Sae Hee Kim ◽  
Sung Hee Jung ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Elderly Patients ◽  
Common Bile Duct Stones ◽  
Bile Duct Stones ◽  
Gallbladder In Situ

Advances in the endoscopic management of common bile duct stones

2014 ◽  
Vol 11 (9) ◽  
pp. 535-544 ◽  
Author(s):  
Guru Trikudanathan ◽  
Mustafa A. Arain ◽  
Rajeev Attam ◽  
Martin L. Freeman
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stones ◽  
Endoscopic Management ◽  
Bile Duct Stones

scholarly journals CLINICAL EFFICIENCY OF OPEN AND ENDOSCOPIC INTERVENTIONS WITH OBSTACLES OF THE TERMINAL DEPARTMENT OF CHOLEDOCH IN PATIENTS WITH GALLSTONE DISEASE OF ELDERLY AND SENILE AGE

2021 ◽  
pp. 43-47
Author(s):  
D. Riazanov ◽  
Yu. Mikheiev ◽  
O. Shpylenko
Keyword(s):  
Bile Duct ◽  
Postoperative Complications ◽  
Common Bile Duct ◽  
Gallstone Disease ◽  
Postoperative Mortality ◽  
Common Bile Duct Stones ◽  
Endoscopic Management ◽  
Bile Duct Stones ◽  
The Common ◽  
Terminal Section

Summary. Purpose. To optimize the tactics of endoscopic interventions for cholelithiasis complicated by obstruction of the terminal portion of the common bile duct to reduce the incidence of postoperative complications and mortality in elderly and senile people. Materials and methods. The results of examination and treatment of 221 elderly and senile patients with cholelithiasis complicated by obstruction of the terminal section of the common bile duct were analyzed. Results. Using of existing methods and proposed new methods of endoscopic management of cholelithiasis complicated by obstruction of the terminal section of the common bile duct allow to reliably reduce the incidence of postoperative complications in elderly and senile patients from 19.8 to 9.5%, postoperative mortality from 10.3 to 2.9% Conclusions. In elderly and senile patients with obstruction of the terminal section of the common bile duct and common bile duct stones who bear high operational risk, endoscopic papillosphincterotomy with stone removal is a sufficient method of treatment. In case of unremovable common bile duct stones, endoscopic papillosphincterotomy and stenting allow to avoid revision of the common bile duct, and in high-risk patients those methods allow to refrain from open surgery.

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