Trial reportThe journal of trauma and acute care surgery2025
A comparative study of extracorporeal shock wave lithotripsy and cholangioscopy-guided lithotripsy in the management of complex biliary stones: A randomized trial.
Trial report in The journal of trauma and acute care surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
backgroundLarge and impacted common bile duct stones (CBDSs) cannot be removed by conventional endoscopic retrograde cholangiopancreatography (ERCP), and extracorporeal shock wave lithotripsy (ESWL) or cholangioscopy-guided lithotripsy is recommended as a second-line treatment. The aim of this study is to compare safety and efficacy of ESWL for difficult CBDS.
methodsPatients at our hospital diagnosed with complex large CBDS between January 2021 and June 2022 were randomly assigned to the ESWL group or the cholangioscopy group for lithotripsy. Our results include clinical and technical success, the mean number of ERCP sessions, and any complications from the procedure.
resultsA total of 84 patients were included assigned to two groups (the ESWL group [42 patients] and the cholangioscopy group [42 patients]). Technical success was 92.85% for the ESWL group and 100% for the cholangioscopy group ( p = 0.19), whereas clinical success was 69% and 88%, respectively ( p = 0.01). The ESWL group had 2.32 ± 0.98 ERCPs, and the cholangioscopy group had 1.13 ± 0.36 ( p < 0.001). The mean lithotripsy sessions were 2.3 ± 0.63 for ESWL and 1.13 ± 0.36 for cholangioscopy ( p < 0.001). Both groups had similar adverse events, except for cutaneous petechiae.
conclusionCompared with ESWL, cholangioscopy-guided lithotripsy is a safe and effective treatment for large and complex CBDSs. LEVEL OF EVIDENCE: Therapeutic/Care Management; Level II.
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