The therapeutic value of ERCP and EST on choledocholithiasis / 中华全科医师杂志

ABSTRACT

1263 patients with choledocholithiasis were treated with endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST) from January 2005 to December 2008, with 1235 (97.8%) cases successfully treated. One-time ERCP removal of the stones was successful in 982 patients, with two times in 129 patients and three times in 124. 1130 patients (89. 5% ) underwent endoscopic nasal biliary drainage (ENBD) after the procedure. 56 patients with refractory stone were treated with intrabiliary plastic stent, among whom 42 were cured through endoscopic retrograde biliary drainage (ERBD) of 1 -3 times. Complications occurred in 29 patients (2. 3% ) with hemorrhage in 8 patients,acute pancreatitis in 17 and perforations in 4. Mortality rate was 0. We concluded that the majority cases of choledocholithiasis can be successfully treated by ERCP, while intrahepatic cholelithiasis and refractory common bile duct stone remained therapeutic challenges. It is also mandatory to evaluate long-term efficacy and complications of ERCP.