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Best Procedure for the Management of Common Bile Duct Stones via the Papilla: Literature Review and Analysis of Procedural Efficacy and Safety
Background: Endoscopic management of common bile duct stones (CBDS) is standard; however, various techniques are performed via the papilla, and the best procedure in terms of both efficacy and safety has not been determined. Methods: Endoscopic procedures were classified into five categories accordi...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7760048/ https://www.ncbi.nlm.nih.gov/pubmed/33255554 http://dx.doi.org/10.3390/jcm9123808 |
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author | Ishii, Shigeto Isayama, Hiroyuki Ushio, Mako Takahashi, Sho Yamagata, Wataru Takasaki, Yusuke Suzuki, Akinori Ochiai, Kazushige Tomishima, Ko Kanazawa, Ryo Saito, Hiroaki Fujisawa, Toshio Shiina, Shuichiro |
author_facet | Ishii, Shigeto Isayama, Hiroyuki Ushio, Mako Takahashi, Sho Yamagata, Wataru Takasaki, Yusuke Suzuki, Akinori Ochiai, Kazushige Tomishima, Ko Kanazawa, Ryo Saito, Hiroaki Fujisawa, Toshio Shiina, Shuichiro |
author_sort | Ishii, Shigeto |
collection | PubMed |
description | Background: Endoscopic management of common bile duct stones (CBDS) is standard; however, various techniques are performed via the papilla, and the best procedure in terms of both efficacy and safety has not been determined. Methods: Endoscopic procedures were classified into five categories according to endoscopic sphincterotomy (EST) and balloon dilation (BD): (1) EST, (2) endoscopic papillary BD (≤10 mm) (EPBD), (3) EST followed by BD (≤10 mm) (ESBD), (4) endoscopic papillary large BD (≥12 mm) (EPLBD), and (5) EST followed by large BD (≥12 mm) (ESLBD). We performed a literature review of prospective and retrospective studies to compare efficacy and adverse events (AEs). Each procedure was associated with different efficacy and AE profiles. Results: In total, 19 prospective and seven retrospective studies with a total of 3930 patients were included in this study. For EST, the complete stone removal rate at the first session, rate of mechanical lithotripsy (ML), and rate of overall AEs in EST were superior to EPBD, but a higher rate of bleeding was found for EST. Based on one retrospective study, complete stone removal rate at the first session, rate of ML, and rate of overall AEs were superior for ESBD vs. EST, and the rate of bleeding for the former was also lower. Complete stone removal rate at the first session and rate of ML for ESLBD were superior to those for EST, with no significant difference in rate of AEs. For EST vs. EPLBD, complete stone removal rate at the first session and rate of ML were superior for the latter. For EPLBD vs. ESLBD, the efficacy and safety were similar. Conclusions: ESBD is considered the best procedure for the management of small CBDS, but strong evidence is lacking. For large CBDS, both ESLBD and EPLBD are similar. |
format | Online Article Text |
id | pubmed-7760048 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-77600482020-12-26 Best Procedure for the Management of Common Bile Duct Stones via the Papilla: Literature Review and Analysis of Procedural Efficacy and Safety Ishii, Shigeto Isayama, Hiroyuki Ushio, Mako Takahashi, Sho Yamagata, Wataru Takasaki, Yusuke Suzuki, Akinori Ochiai, Kazushige Tomishima, Ko Kanazawa, Ryo Saito, Hiroaki Fujisawa, Toshio Shiina, Shuichiro J Clin Med Review Background: Endoscopic management of common bile duct stones (CBDS) is standard; however, various techniques are performed via the papilla, and the best procedure in terms of both efficacy and safety has not been determined. Methods: Endoscopic procedures were classified into five categories according to endoscopic sphincterotomy (EST) and balloon dilation (BD): (1) EST, (2) endoscopic papillary BD (≤10 mm) (EPBD), (3) EST followed by BD (≤10 mm) (ESBD), (4) endoscopic papillary large BD (≥12 mm) (EPLBD), and (5) EST followed by large BD (≥12 mm) (ESLBD). We performed a literature review of prospective and retrospective studies to compare efficacy and adverse events (AEs). Each procedure was associated with different efficacy and AE profiles. Results: In total, 19 prospective and seven retrospective studies with a total of 3930 patients were included in this study. For EST, the complete stone removal rate at the first session, rate of mechanical lithotripsy (ML), and rate of overall AEs in EST were superior to EPBD, but a higher rate of bleeding was found for EST. Based on one retrospective study, complete stone removal rate at the first session, rate of ML, and rate of overall AEs were superior for ESBD vs. EST, and the rate of bleeding for the former was also lower. Complete stone removal rate at the first session and rate of ML for ESLBD were superior to those for EST, with no significant difference in rate of AEs. For EST vs. EPLBD, complete stone removal rate at the first session and rate of ML were superior for the latter. For EPLBD vs. ESLBD, the efficacy and safety were similar. Conclusions: ESBD is considered the best procedure for the management of small CBDS, but strong evidence is lacking. For large CBDS, both ESLBD and EPLBD are similar. MDPI 2020-11-25 /pmc/articles/PMC7760048/ /pubmed/33255554 http://dx.doi.org/10.3390/jcm9123808 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Ishii, Shigeto Isayama, Hiroyuki Ushio, Mako Takahashi, Sho Yamagata, Wataru Takasaki, Yusuke Suzuki, Akinori Ochiai, Kazushige Tomishima, Ko Kanazawa, Ryo Saito, Hiroaki Fujisawa, Toshio Shiina, Shuichiro Best Procedure for the Management of Common Bile Duct Stones via the Papilla: Literature Review and Analysis of Procedural Efficacy and Safety |
title | Best Procedure for the Management of Common Bile Duct Stones via the Papilla: Literature Review and Analysis of Procedural Efficacy and Safety |
title_full | Best Procedure for the Management of Common Bile Duct Stones via the Papilla: Literature Review and Analysis of Procedural Efficacy and Safety |
title_fullStr | Best Procedure for the Management of Common Bile Duct Stones via the Papilla: Literature Review and Analysis of Procedural Efficacy and Safety |
title_full_unstemmed | Best Procedure for the Management of Common Bile Duct Stones via the Papilla: Literature Review and Analysis of Procedural Efficacy and Safety |
title_short | Best Procedure for the Management of Common Bile Duct Stones via the Papilla: Literature Review and Analysis of Procedural Efficacy and Safety |
title_sort | best procedure for the management of common bile duct stones via the papilla: literature review and analysis of procedural efficacy and safety |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7760048/ https://www.ncbi.nlm.nih.gov/pubmed/33255554 http://dx.doi.org/10.3390/jcm9123808 |
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