Simplified single-session EUS-guided transhepatic antegrade stone removal for management of choledocholithiasis in patients with surgically altered anatomy
Tingting Yu1
Suning Hou1
Haiming Du1
Wei Zhang1
Jiao Tian1
Yankun Hou1
Jun Yao2
Senlin Hou1
Lichao Zhang1
1.The Second Hospital of Hebei Medical University,Shijiazhuang,Hebei,P.R.China2.Jinan University of Second Clinical Medical Sciences,Shenzhen People’s Hospital,Shenzhen,Guangdong,P.R.China
摘要：Background:Endoscopic ultrasound(EUS)-guided transhepatic antegrade stone removal(TASR)has been reserved for choledocholi-thiasis after failed endoscopic retrograde cholangiopancreatography(ERCP)in recent years.The aim of this study was to evaluate the techniques,feasibility,and safety of simplified single-session EUS-TASR for choledocholithiasis in patients with surgically altered anatomy(SAA).
Methods:A retrospective database of patients with SAA and choledocholithiasis from the Second Hospital of Hebei Medical University(Shijiazhuang,China)between August 2020 and February 2023 was performed.They all underwent single-session EUS-TASR after ERCP failure.Basic characteristics of the patients and details of the procedures were collected.The success rates and ad-verse events were evaluated and discussed.
Results:During the study period,13 patients underwent simplified single-session EUS-TASR as a rescue procedure(8 males,median age,64.0[IQR,48.5-69.5]years).SAA consisted of four Whipple procedures,one Billroth II gastrectomy,four gastrectomy with Roux-en-Y anastomoses,and four hepaticojejunostomy with Roux-en-Y anastomoses.The technical success rate was 100%and successful bile duct stone removal was achieved in 12 of the patients(92.3%).Adverse events occurred in two patients(15.4%),while one turned to laparoscopic surgery and the other was managed conservatively.
Conclusions:Simplified single-session EUS-TASR as a rescue procedure after ERCP failure appeared to be effective and safe in the management of choledocholithiasis in patients with SAA.But further evaluation of this technique is still needed,preferably through prospective multicenter trials.
机标关键词：managementiasiwithalteredanatomyantegradecholedocholitheus-guided
论文发表日期：2024-08-30
在线出版日期：2026-07-17（本平台首次上网日期，不代表文献的发表时间）
页数：5( 320-324 )
英文信息