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Direct peroral cholangioscopy in the management of difficult biliary stones: a new tool to confirm common bile duct clearance. Results of a preliminary study

2019-03Journal article Open access
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dc.contributor.authorAnderloni, A.
dc.contributor.authorAuriemma, F.
dc.contributor.authorFugazza, A.
dc.contributor.authorTroncone, E.
dc.contributor.authorMaia, L.
dc.contributor.authorMaselli, R.
dc.contributor.authorCarrara, S.
dc.contributor.authorD'Amico, F.
dc.contributor.authorBelletrutti, P.
dc.contributor.authorRepici, A.
dc.date.accessioned2020-05-22T16:13:24Z
dc.date.available2020-05-22T16:13:24Z
dc.date.issued2019-03
dc.description.abstractBackground and aims: Endoscopic sphincterotomy (ES) with stone extraction is the standard treatment for choledocholithiasis. After stone retrieval, balloon-occluded cholangiography is generally performed to confirm bile duct clearance but can miss residual stones particularly in patients with residual small-sized stones, a large bile duct or pneumobilia. In addition, difficult common bile duct (CBD) stones requiring advanced endoscopic techniques for retrieval are a potential risk factor for choledocholithiasis recurrence. Methods: We performed a retrospective evaluation of a prospectively maintained procedures database. From July 2016 to December 2017, all patients with difficult CBD stones who underwent endoscopic retrograde cholangiopancreatography (ERCP) with papillary balloon dilation-assisted stone retrieval and subsequent direct per-oral cholangioscopy (DPOC) using standard gastroscopes to confirm CBD clearance were analyzed. Results: Thirty-six patients who underwent ERCP and DPOC were included. Technical success, defined as deep intubation of CBD with hepatic hilum visualization, was achieved in 31 of 36 patients (86%). During DPOC, residual CBD stones were visualized and removed in 7 of 31 patients (22.5%). After a mean of 241 +/- 56 days of follow-up post-DPOC, no serious adverse events were reported, and there was no evidence or suspicion of recurrent choledocholithiasis. Conclusions: Direct per-oral cholangioscopy immediately following difficult CBD stone removal was safe, feasible and accurate. In this setting, DPOC at the time of ERCP appears to be a very useful tool to achieve complete clearance of choledocholithiasis.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAnderloni A, Auriemma F, Fugazza A, et al. Direct peroral cholangioscopy in the management of difficult biliary stones: a new tool to confirm common bile duct clearance. Results of a preliminary study. J Gastrointestin Liver Dis. 2019;28(1):89‐94. doi:10.15403/jgld.2014.1121.281.bilpt_PT
dc.identifier.doi10.15403/jgld.2014.1121.281.bilpt_PT
dc.identifier.issn1841-8724
dc.identifier.issn1842-1121
dc.identifier.urihttp://hdl.handle.net/10400.16/2398
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherEditura Medicală Universitară "Iuliu Haţieganu"pt_PT
dc.relation.publisherversionhttp://www.jgld.ro/wp/archive/y2019/n1/a15/pt_PT
dc.subjectcholangioscopypt_PT
dc.subjectERCPpt_PT
dc.subjectdifficult biliary stonespt_PT
dc.subjectDPOCpt_PT
dc.titleDirect peroral cholangioscopy in the management of difficult biliary stones: a new tool to confirm common bile duct clearance. Results of a preliminary studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceRomaniapt_PT
oaire.citation.endPage94pt_PT
oaire.citation.issue1pt_PT
oaire.citation.startPage89pt_PT
oaire.citation.titleJournal of gastrointestinal and liver diseases : JGLDpt_PT
oaire.citation.volume28pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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