Gastrointestinal endoscopy · 2026
Endoscopic management of cystic duct remnant stones causing postcholecystectomy syndrome: a multicenter experience.
СтатьяНазвание и аннотация: Перевод в очереди
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Arif Yousif, Tielleman Thomas, Alchirazi Khaled, Kolb Jennifer, Bahdi Firas, Awadalla Mohanad, Phan Jennifer, Shah Shawn, Gabr Moamen, Pleskow Douglas, Bilal Mohammad, Adler Douglas G, Issa Danny
Аннотация
BACKGROUND AND AIMS: Cystic duct remnant (CDR) stones are an under-recognized biliary cause of postcholecystectomy syndrome (PCS). Surgical excision has been the traditional treatment; however, ERCP may offer a less invasive alternative.
METHODS: We conducted a retrospective multicenter study of patients with PCS who underwent ERCP for CDR stones. The primary outcome was technical success (complete stone clearance); secondary outcomes were clinical success and adverse events.
RESULTS: Twenty-one patients were included (mean age, 50 ± 17 years). Technical and clinical success rates were 95% (20 of 21) and 91% (19 of 21), respectively. Balloon sweep alone achieved clearance in 43%; cholangioscopy was required in 43%, with electrohydraulic lithotripsy (EHL) used in 89% of those cases. Post-ERCP pancreatitis occurred in 2 patients (10%), both mild.
CONCLUSIONS: ERCP is highly effective and safe for symptomatic CDR stones. Cholangioscopy with EHL is frequently necessary and should be anticipated, particularly for impacted or large stones.
METHODS: We conducted a retrospective multicenter study of patients with PCS who underwent ERCP for CDR stones. The primary outcome was technical success (complete stone clearance); secondary outcomes were clinical success and adverse events.
RESULTS: Twenty-one patients were included (mean age, 50 ± 17 years). Technical and clinical success rates were 95% (20 of 21) and 91% (19 of 21), respectively. Balloon sweep alone achieved clearance in 43%; cholangioscopy was required in 43%, with electrohydraulic lithotripsy (EHL) used in 89% of those cases. Post-ERCP pancreatitis occurred in 2 patients (10%), both mild.
CONCLUSIONS: ERCP is highly effective and safe for symptomatic CDR stones. Cholangioscopy with EHL is frequently necessary and should be anticipated, particularly for impacted or large stones.