Abstract
Evaluation of the Safety and Effectiveness of Medium Endoscopic Sphincterotomy followed by Papillary Balloon Dilation (ESBD) in the treatment Of Common Bile Duct Stones: A Metropolitan Medical Center Experience
John Reuel F. Magan/ Arlinking O. Go/ Evan G. Ong
Metropolitan Medical Center
Significance: Endoscopic therapy is the first-line treatment for patients with common bile duct stones. We employed medium endoscopic sphincterotomy followed by papillary balloon dilation (ESBD), and retrospectively evaluated its safety and effectiveness.
Methodology: Patients with choledocholithiasis (n=167) who underwent ERCP with ESBD at Metropolitan Medical Center from 2014 to December 2022 were consecutively enrolled, retrospectively. We evaluate the overall stone extraction rate and the incidence of immediate complications (primarily due to bleeding and perforation).
Results: The overall success rate of complete stone extraction was 82.8 % (135/167). On univariate analysis, there were higher usage of stents on patients with incomplete stone extraction (61.3% vs 6.8%, p< 0.001) and on patients with periprocedural bleeding (37.9% vs 16.1%, p<0.021). Initial stone size significantly determines the outcome of stone extraction (1.465 vs 1.073, p<0.008). On quantitative multivariate analysis, the odds of incomplete stone extraction among those with initial stone size of > 1.4cm are more than 6 times compared to those with initial stone size of <1.4cm holding all other variables constant (p<0.001).
Keywords: Endoscopic sphincterotomy, Endoscopic papillary balloon dilation, Common bile duct stones
Important Dates to Remember
| JRRE Activities 2023-2024 |
Proposed Dates |
|---|---|
| Resumption of face-to-face Evidence-Based Medicine Workshop Venue to be announced once finalized. |
July 21, 2023 (Friday), 1-5pm |
| Monthly Critical Appraisal of Topics Conferences to be gaciliated by Research Coordinators per Institution | Monthly Critical Appraisal of Topics Conferences per Institution |
| CAT Plenary/Liver Con Dates: September 23, 2023 December 16, 2023 March 2024 (During the JAC) Resumption of face-to-face Quarterly Critical Appraisal of Topics facilitated by the JRRE |
2 Clinical scenarios and articles are to be sent to institutions each on August 2023, November 2023, and February 2024; |
| Hybrid Research Workshop 4 week asynchronous via Moodle, followed by a 1 day on-site Onsite Workshop Research Protocol Presentation for Level I GI Fellows-In-Training - Research Protocol Presentation: August 12, 2023 - Research Forums of the Tripartite Societies |
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| Research Manuscript Workshop for level II GI Fellows-In-Training | January 6, 2024 |