Intrabiliary ultrasound applied to endoscopic extraction of choledochal stones.

IF 0.9 4区医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Asian Biomedicine Pub Date : 2026-04-30 eCollection Date: 2026-02-01 DOI:10.2478/abm-2026-0004

Liang Ye, Huaiyang Cai, Yingwei Wang, Weiqiang Guo

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引用次数: 0

Abstract

Background: Although ERCP with endoscopic sphincterotomy is effective for choledocholithiasis, small residual stones may be missed by cholangiography, and intraductal ultrasound may improve detection and reduce recurrence.

Objective: To observe the value of intraductal ultrasound (IDUS) in endoscopic extraction of choledocholithiasis.

Methods: We retrospectively analyzed 148 patients with choledocholithiasis who underwent endoscopic retrograde cholangiopancreatography (ERCP) combined with endoscopic sphincterotomy (EST). IDUS was performed to observe whether there were any residual choledocholithiasis stones in those whose previous choledocholithiasis treatment indicated complete clearance; ERCP combined with EST was repeated to retrieve larger residual stones (≥3 mm). Postoperative follow-up was conducted to monitor the recurrence of choledocholithiasis and its influencing factors.

Results: After 148 cases of endoscopic ERCP combined with EST, cholangiography confirmed the complete removal of choledochal stones. Notably, 61 cases were found to have residual stones, and 21 of them had residual stones ≥3 mm; these 21 cases were repeated until the stones were completely removed. After 3-24 months of follow-up, IDUS revealed that the stone recurrence rates were 8.33% (9/108) for 108 cases with complete stone removal and 62.50% (25/40) for 40 cases with residual stones. The difference was statistically significant (P < 0.01). The cumulative recurrence rates during the 24-month postoperative period were also significantly different (88.40% and 14.40%, respectively, P < 0.01). The results of multivariate analysis showed that choledocholithiasis, common bile duct (CBD) diameter, and angle were independent risk factors for stone recurrence, as indicated by IDUS (P < 0.05).

Conclusions: IDUS can detect choledocholithiasis, particularly small stones (<3 mm), which are challenging to visualize with cholangiography. IDUS can assist in ERCP combined with EST to reduce the recurrence of postoperative stones.

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胆道超声在内镜下胆道结石取出术中的应用。

背景：虽然ERCP联合内镜下括约肌切开术治疗胆总管结石是有效的，但残余的小结石可能会被胆管造影遗漏，导管内超声可以提高发现率，减少复发。目的：观察导管内超声（IDUS）在内镜下胆总管结石取出术中的应用价值。方法：回顾性分析148例经内镜逆行胆管造影（ERCP）联合内镜下括约肌切开术（EST）治疗的胆总管结石患者。对既往胆总管结石治疗完全清除的患者行IDUS观察是否有残余胆总管结石；重复ERCP联合EST检查较大残余结石（≥3mm）。术后随访观察胆总管结石复发情况及影响因素。结果：148例经内镜ERCP联合EST行胆道造影证实胆总管结石完全切除。值得注意的是，有61例结石残留，其中21例结石残留≥3 mm；这21例重复手术，直到结石完全取出。随访3-24个月，IDUS显示结石完全取出的108例复发率为8.33%(9/108)，残留结石的40例复发率为62.50%（25/40）。差异有统计学意义（P < 0.01）。两组术后24个月累计复发率分别为88.40%和14.40%,P < 0.01)。多因素分析结果显示，IDUS显示胆总管结石、总胆管（CBD）直径、角度是结石复发的独立危险因素（P < 0.05）。结论：IDUS可检出胆总管结石，尤其是小结石。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asian Biomedicine 医学-医学：研究与实验

CiteScore

1.20

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Asian Biomedicine: Research, Reviews and News (ISSN 1905-7415 print; 1875-855X online) is published in one volume (of 6 bimonthly issues) a year since 2007. [...]Asian Biomedicine is an international, general medical and biomedical journal that aims to publish original peer-reviewed contributions dealing with various topics in the biomedical and health sciences from basic experimental to clinical aspects. The work and authorship must be strongly affiliated with a country in Asia, or with specific importance and relevance to the Asian region. The Journal will publish reviews, original experimental studies, observational studies, technical and clinical (case) reports, practice guidelines, historical perspectives of Asian biomedicine, clinicopathological conferences, and commentaries Asian biomedicine is intended for a broad and international audience, primarily those in the health professions including researchers, physician practitioners, basic medical scientists, dentists, educators, administrators, those in the assistive professions, such as nurses, and the many types of allied health professionals in research and health care delivery systems including those in training.