ArticleAnnals of gastroenterology
Predictors of a need for cholangioscopy-guided electrohydraulic lithotripsy in the management of difficult common bile duct stones.
Article in Annals of gastroenterology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Optimizing the prioritization of cholangioscopy-guided electrohydraulic lithotripsy: the role of stone characteristics and cost-efficacy.Annals of gastroenterologyArticle
- Authors' reply.Annals of gastroenterologyArticle
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: While standard endoscopic methods effectively clear most common bile duct stones, complex cases require specialized management. This study compared the effectiveness of cholangioscopy-guided electrohydraulic lithotripsy (EHL) against conventional techniques for treating difficult common bile duct stones (DBS). Methods: This retrospective study included 436 patients who underwent endoscopic retrograde cholangiopancreatography between April 2020 and April 2024. Demographic, laboratory and procedural data were recorded. Categorical regression identified predictors for EHL, and classification tree analysis was used to develop a prioritization algorithm. Results: Among patients with DBS (305/436, 70%), conventional methods succeeded in 28.9% (88/305). Endoscopic papillary large balloon dilation followed failed first-line techniques in 115 cases, with a 21.7% success rate. EHL was used in 192 patients, achieving a 98.4% success rate. Multivariate analysis showed that DBS (P<0.001), absence of wedged stones in the ampulla of Vater (P<0.001), and small papillae (P=0.002) were strong independent predictors for EHL use, with DBS being the most significant. Conclusions: DBS, absence of wedged stones in Vater and small papillae are key predictors of the need for cholangioscopy-guided EHL. Given its high success rate and comparable safety profile, EHL should be considered an early-line treatment in selected cases.
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