Efficacy of Spyglass-Guided Electrohydraulic Lithotripsy in Difficult Bile Duct Stones |
| |
Authors: | Abdulrahman M. Aljebreen Othman R. Alharbi Nahla Azzam Majid A. Almadi |
| |
Affiliation: | 1.Gastroenterology Division, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia;2.Gastroenterology Division, The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada |
| |
Abstract: | Background/Aims:We aimed to evaluate the efficacy and safety of Spyglass-guided electrohydraulic lithotripsy (EHL) for difficult common bile duct stones (CBD) not amenable to conventional endoscopic therapy.Design:A retrospective study evaluating the efficacy of Spyglass-guided EHL in treating difficult CBD stones, in a single tertiary care center.Patients and Methods:All patients who underwent Spyglass-guided EHL from 2012 to 2013 were compared with a historical cohort who had ECSWL.Results:A total number of 13 patients underwent Spyglass-guided EHL, 8 (61.5%) of them were males. The mean age was 46.5 ± 5.6 years. Bile duct clearance was achieved in 13 (100%) of them. Seventy-six percent required only one Endoscopic Retrograde Cholangiopancreatography (ERCP) to clear the CBD, 7.7% required two ERCPs, and 15.4% required three ERCPs. Adverse effects (cholangitis) occurred in one patient (10%), whereas only 30 patients (64.4%) of the ESWL group had complete CBD stone clearance. Thirty-seven percent required one ERCP to clear the CBD, 35.6% required two ERCPs, and 20% required three ERCPs. Adverse effects happened in seven (15.5%) patients, where five (11%) had cholangitis and two (4.4%) had pancreatitis.Conclusion:Although a retrospective design with a small sample size, we concluded that Spyglass-guided EHL is an effective procedure in treating difficult CBD stones. |
| |
Keywords: | Biliary stones ESWL EHL spyglass |
|
|