Efficacy and safety of endoscopic retrograde cholangiopancreatography in the treatment of bile duct stones.

Abstract

Background: The current surgical treatments for bile duct stones (BDSs) demonstrate suboptimal efficacy, warranting further exploration of superior therapies or improvement of existing surgical protocols.

Aim: To assess the therapeutic efficacy and safety profiles of endoscopic retrograde cholangiopancreatography (ERCP) vs common bile duct exploration (CBDE) in BDS treatment.

Methods: This study enrolled 103 consecutive patients with BDSs treated at the First People's Hospital of Changde from January 2024 to January 2025, with 53 patients undergoing ERCP (ERCP group) and 50 receiving conventional CBDE (CBDE group). Comprehensive comparative analyses were conducted across multiple parameters, including clinical efficacy, surgical success rate, safety (bile leakage incidence, surgical site infection, acute pancreatitis, and acute cholangitis), postoperative biochemical markers (total bilirubin and serum amylase), surgery-related metrics (stone removal time, procedure duration, intraoperative blood loss, and hospitalization time), and postoperative recovery indicators (time to intestinal recovery, jaundice resolution, biliary drainage removal, and postoperative activity recovery).

Results: The ERCP group demonstrated markedly superior overall efficacy than the CBDE group, with similar surgical success rates and comparable stone removal durations. Importantly, patients undergoing ERCP experienced fewer complications overall, required less operative time, had minimal intraoperative blood loss, and needed shorter hospitalization periods. Recovery parameters such as bowel function recovery, jaundice resolution, biliary stent removal, and normal activity resumption, were significantly improved in the ERCP group. Both groups demonstrated substantial postoperative reductions in total bilirubin and amylase, with no significant intergroup differences.

Conclusion: ERCP demonstrates effectiveness and safety in managing BDSs, thereby providing notable clinical benefits that support its broader implementation in medical practice.