BACKGROUND: Patients with choledochocystolithiasis generally undergo endoscopic sphincterotomy (ES) followed by elective cholecystectomy. They can experience the development of recurrent biliary events while waiting for their scheduled surgery. AIM: This study investigated whether stent insertion before cholecystectomy influences the rate of complications. METHODS: The study compared retrospective and prospective groups of patients with choledochocystolithiasis who underwent ES with or without prophylactic common bile duct stent insertion before cholecystectomy. The rate of emergency cholecystectomies and biliary complications during the waiting period before the elective procedure was analyzed. RESULTS: For the study, 162 patients with choledochocystolithiasis who underwent endoscopic retrograde cholangiopancreatography (ERCP) with ES were divided to two subgroups. Group A included 52 patients with stent insertion (mean age, 58.3 ± 19.4 years), and group B included 110 patients with no stent insertion (mean age, 61.4 ± 17.7 years) (p = 0.32). Males made up 33.3% of group A and 53.7% of group B (p = 0.018). The median time to elective cholecystectomy (open or laparoscopic) was 41.5 days for the patients without bile duct stent insertion before cholecystectomy and 53.5 days for the patients who had the stent insertion before cholecystectomy (p = 0.63). Repeat emergency ERCP due to acute cholangitis was 5.6% in group A and 1.0% in group B (p = 0.43). Emergency cholecystectomy rates due to acute cholecystitis after ES were 15.4% in group A and 14.5% in group B (p = 1.00). No mortality occurred. CONCLUSIONS: According to the study findings, prophylactic stent insertion during ERCP before cholecystectomy has no impact on biliary complications.
BACKGROUND:Patients with choledochocystolithiasis generally undergo endoscopic sphincterotomy (ES) followed by elective cholecystectomy. They can experience the development of recurrent biliary events while waiting for their scheduled surgery. AIM: This study investigated whether stent insertion before cholecystectomy influences the rate of complications. METHODS: The study compared retrospective and prospective groups of patients with choledochocystolithiasis who underwent ES with or without prophylactic common bile duct stent insertion before cholecystectomy. The rate of emergency cholecystectomies and biliary complications during the waiting period before the elective procedure was analyzed. RESULTS: For the study, 162 patients with choledochocystolithiasis who underwent endoscopic retrograde cholangiopancreatography (ERCP) with ES were divided to two subgroups. Group A included 52 patients with stent insertion (mean age, 58.3 ± 19.4 years), and group B included 110 patients with no stent insertion (mean age, 61.4 ± 17.7 years) (p = 0.32). Males made up 33.3% of group A and 53.7% of group B (p = 0.018). The median time to elective cholecystectomy (open or laparoscopic) was 41.5 days for the patients without bile duct stent insertion before cholecystectomy and 53.5 days for the patients who had the stent insertion before cholecystectomy (p = 0.63). Repeat emergency ERCP due to acute cholangitis was 5.6% in group A and 1.0% in group B (p = 0.43). Emergency cholecystectomy rates due to acute cholecystitis after ES were 15.4% in group A and 14.5% in group B (p = 1.00). No mortality occurred. CONCLUSIONS: According to the study findings, prophylactic stent insertion during ERCP before cholecystectomy has no impact on biliary complications.
Authors: Jan Siert K Reinders; Annemarie Goud; Robin Timmer; Philip M Kruyt; Philip M Kruijt; Ben J M Witteman; Niels Smakman; Ronald Breumelhof; Sandra C Donkervoort; Jeroen M Jansen; Joos Heisterkamp; Marina Grubben; Marina Grobben; Bert van Ramshorst; Djamila Boerma Journal: Gastroenterology Date: 2010-03-02 Impact factor: 22.682
Authors: Djemila Boerma; Erik A J Rauws; Yolande C A Keulemans; Ignace M C Janssen; Clemens J M Bolwerk; Ron Timmer; Egge J Boerma; Huug Obertop; Kees Huibregtse; Dirk J Gouma Journal: Lancet Date: 2002-09-07 Impact factor: 79.321
Authors: Anandi H W Schiphorst; Marc G H Besselink; Djamila Boerma; Robin Timmer; Marinus J Wiezer; Karel J van Erpecum; Ivo A M J Broeders; Bert van Ramshorst Journal: Surg Endosc Date: 2008-02-13 Impact factor: 4.584
Authors: Hyeon Jeong Goong; Jong Ho Moon; Yun Nah Lee; Hyun Jong Choi; Seo-Youn Choi; Moon Han Choi; Min Jin Kim; Tae Hoon Lee; Sang-Heum Park; Hae Kyung Lee Journal: Gut Liver Date: 2017-05-15 Impact factor: 4.519