Figure 1.
Female patient, 61 years old, with choledocholithiasis, who underwent ERCP combined with EST for stone extraction. (A) ERCP showed multiple stone shadows with diameters of 10–14 mm in the whole section of the choledocholithiasis (arrows). (B, C) ERCP combined with EST, no stone was seen on imaging after stone removal, and IDUS showed 2 <3 mm diameter stones in the middle part of the CBD (arrows). (D) Repeat extraction after lithotripsy, IDUS shows that the lower part of the CBD is ≥3 mm in diameter, and the residual stone has been removed. CBD, common bile duct; ERCP, endoscopic retrograde cholangiopancreatography; EST, endoscopic sphincterotomy; IDUS, intraductal ultrasound.
Table 1.
Comparison of data related to patients with complete stone removal and residual stones after ERCP combined with EST stone extraction
| Group | Male/female | Age (years) | Diameter of CBD (mm) | Angle of CBD (°) | Maximum diameter of stones (mm) |
|---|---|---|---|---|---|
| Removal group (n = 108) | 36/72 | 60.10 ± 15.30 | 10.20 ± 2.58 | 143.76 ± 10.65 | 10.03 ± 3.91 |
| Residual stone group (n = 40) | 16/24 | 62.30 ± 18.70 | 12.67 ± 3.21 | 130.98 ± 11.41 | 12.15 ± 3.13 |
| χ2/t value | 0.98 | 0.72 | 5.17 | 6.91 | 1.02 |
| P value | 0.32 | 0.46 | <0.01 | <0.01 | 0.32 |
Table 2.
Comparison of relevant data of patients with and without recurrence after ERCP combined with EST stone extraction
| Group | Male/female | Age (years) | Diameter of CBD (mm) | Angle of CBD (°) | Maximum diameter of stones (mm) |
|---|---|---|---|---|---|
| Recurrence group (n = 34) | 11/23 | 66.60 ± 15.80 | 12.63 ± 3.46 | 131.79 ± 12.05 | 11.40 ± 0.38 |
| Non-recurrence group (n = 114) | 41/73 | 59.20 ± 16.10 | 10.79 ± 2.88 | 140.49 ± 12.13 | 11.30 ± 0.39 |
| χ2/t value | 0.97 | 2.21 | 3.12 | 3.67 | 0.09 |
| P value | 0.32 | 0.28 | <0.01 | <0.01 | 0.94 |
Table 3.
Recurrence of choledocholithiasis after ERCP combined with EST lithotripsy risk factor analysis
| Factor | P | OR | Wals | β |
|---|---|---|---|---|
| Remnant biliary stone | <0.05 | 12.72 | 35.39 | 2.54 |
| Diameter of CBD | <0.05 | 1.24 | 12.50 | 0.22 |
| Angle of CBD | <0.05 | 0.95 | 11.50 | 11.50 |
Figure 2.
Kaplan–Meier curve of the cumulative no recurrence rate in the cleared versus residual stone group after ERCP combined with EST choledochotomy. CBD, common bile duct; ERCP, endoscopic retrograde cholangiopancreatography; EST, endoscopic sphincterotomy.