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A case of pancreatic duct stones treated with electrohydraulic lithotripsy through a duodenal ulcer.

ABSTRACT: Video 1Crush the large-sized stones directly using an electrohydraulic lithotripsy device.

SUBMITTER: Hosaka S

PROVIDER: S-EPMC9669497 | biostudies-literature | 2022 Nov

REPOSITORIES: biostudies-literature

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A case of pancreatic duct stones treated with electrohydraulic lithotripsy through a duodenal ulcer.

Hosaka Shosuke S Maejima Kyohei K Ito Shun S Sato Shin-Ichiro SI Ono Satoshi S

VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy 20220924 11

Video 1Crush the large-sized stones directly using an electrohydraulic lithotripsy device. ...[more]

PMID: 36407041

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Project description:BackgroundMechanical lithotripsy produces stone fragments that are not easily detected by cholangiography and is a potential cause of recurrence of common bile duct stones (CBDS). This study aims to clarify whether 100 ml saline irrigation after mechanical lithotripsy reduces the recurrent rate of CBDS.MethodsIn this randomized controlled trial performed at the Surgical Endoscopy Center, the First Hospital of Lanzhou University between May 10, 2019, and Dec 31, 2020, patients undergoing endoscopic mechanical lithotripsy were randomly assigned to receive saline irrigation (study group) or no irrigation (control group). The saline irrigation was given 100 ml saline pulse irrigation after cholangiography showed no residual stones. Patients were followed up for at least 24 months after endoscopic stone removal to assess the recurrence of CBDS. This study was registered with ClinicalTrials.gov (NCT03937037).FindingsDuring the median follow-up period of 35.6 months (interquartile range, 26.0-40.7), 43 of the 180 patients had stone recurrence (24%). The frequency of recurrence of CBD stones was 12.22% in the saline irrigation group and 35.56% in the control group, with a difference of 23.33% between the two groups (95% confidence interval [CI], 11.35%-35.32%, p < 0.001). Multivariable Cox proportional hazards analyses showed that constipation (hazard risk [HR] 2.42; 95% CI, 1.22-4.80, p = 0.012), periampullary diverticulum (PAD) (HR 3.06; 95% CI, 1.62-5.79, p < 0.001), and total to direct bilirubin ratio (HR 1.48; 95% CI, 1.21-1.81, p < 0.001) were independent risk factors for the recurrence of CBDS. Saline irrigation was the only preventive factor for the recurrence of CBDS (HR 0.22; 95% CI, 0.11-0.44, p < 0.001).InterpretationFor patients with CBDS requiring mechanical lithotripsy, 100 ml saline irrigation effectively reduces the recurrent rate of CBDS after endoscopic stone removal.FundingThis work was supported by National Natural Science Foundation of China (32160255); Natural Science Foundation of Gansu Province (22JR5RA898, 20JR10RA676); Science and Technology Planning Project of Chengguan District in Lanzhou (2020JSCX0043).

Dataset Information

A case of pancreatic duct stones treated with electrohydraulic lithotripsy through a duodenal ulcer.

Publications

A case of pancreatic duct stones treated with electrohydraulic lithotripsy through a duodenal ulcer.

Similar Datasets

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