Endoscopic treatment of choledocholithiasis in patients with decomipensated cirrhosis / 中华消化内镜杂志

ABSTRACT

ObjectiveTo explore the safety and efficacy of endoscopic treatment for choledocholithiasis in patients with decompensated cirrhosis.MethodsA total of 104 cases of choledocholithiasis with decompensated cirrhosis were treated by ERCP in our hospital between January 2001 and March 2011.ChildPugh grading and model for end stage liver diseases (MELD) were investigated pre-ERCP and 2 weeks post-ERCP.Complication and mortality during the follow-up were recorded.ResultsThe success rates of complete stone retrieval was 92.3％ (96/104),and plastic stent was placed in other 8.Major complications ineluded post-ERCP bleeding in 9 cases (8.7％) and pancreatitis in 8 (7.7％ ).MELD score valuated 2weeks after ERCP ( 10.1 ± 6.3 ) was significantly lower than that of pre-ERCP ( 1 1.9 ± 6.2,t =2.22,P ＜0.05).The Child-Pugh grading before ERCP of 104 patients were 28 in grade A (26.9％ ),52 in grade B (50.0％ ) and 24 in grade C (23.1％ ),which was significantly different from those of 2 weeks after ERCP (40/52/12).No death was recorded during hospital stay for choledocholithiasis,and 2 patients of Child-Pugh grade C died in 3 months after discharge.ConclusionERCP is an effective method for choledocholi-thiasis in patients with decompensated cirrhosis.The main severe complication was post-ERCP bleeding.Those patients with decompensated cirrhosis would benefit from ERCP if we took effective measures.