EUS and ERCP in the Same Session for Biliary Stones: From Risk Stratification to Treatment Strategy in Different Clinical Conditions
Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and stone extraction is the treatment of choice for choledocholithiasis, reaching a successful clearance of the common bile duct (CBD) in up to 90% of the cases. Endoscopic ultrasound (EUS) has the best diagnostic accuracy for...
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| Format: | Article |
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MDPI AG
2021-09-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/57/10/1019 |
| _version_ | 1797513972178485248 |
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| author | Pietro Fusaroli Andrea Lisotti |
| author_facet | Pietro Fusaroli Andrea Lisotti |
| author_sort | Pietro Fusaroli |
| collection | DOAJ |
| description | Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and stone extraction is the treatment of choice for choledocholithiasis, reaching a successful clearance of the common bile duct (CBD) in up to 90% of the cases. Endoscopic ultrasound (EUS) has the best diagnostic accuracy for CBD stones, its sensitivity and specificity range being 89–94% and 94–95%, respectively. Traditionally seen as two separate entities, the two worlds of EUS and ERCP have recently come together under the new discipline of bilio-pancreatic endoscopy. Nevertheless, the complexity of both EUS and ERCP led the European Society of Gastrointestinal Endoscopy to identify quality in endoscopy as a top priority in its recent EUS and ERCP curriculum recommendations. The clinical benefits of performing EUS and ERCP in the same session are several, such as benefiting from real-time information from EUS, having one single sedation for both the diagnosis and the treatment of biliary stones, reducing the risk of cholangitis/acute pancreatitis while waiting for ERCP after the EUS diagnosis, and ultimately shortening the hospital stay and costs while preserving patients’ outcomes. Potential candidates for the same session approach include patients at high risk for CBD stones, symptomatic individuals with status post-cholecystectomy, pregnant women, and those unfit for surgery. This narrative review discusses the main technical aspects and evidence from the literature about EUS and ERCP in the management of choledocholithiasis. |
| first_indexed | 2024-03-10T06:25:04Z |
| format | Article |
| id | doaj.art-8b3a9fc331b1460386f4532e4621170c |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T06:25:04Z |
| publishDate | 2021-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-8b3a9fc331b1460386f4532e4621170c2023-11-22T19:03:31ZengMDPI AGMedicina1010-660X1648-91442021-09-015710101910.3390/medicina57101019EUS and ERCP in the Same Session for Biliary Stones: From Risk Stratification to Treatment Strategy in Different Clinical ConditionsPietro Fusaroli0Andrea Lisotti1Gastrointestinal Unit, Department of Medical and Surgical Sciences, Hospital of Imola, University of Bologna, Via Montericco 4, 40026 Imola, BO, ItalyGastrointestinal Unit, Department of Medical and Surgical Sciences, Hospital of Imola, University of Bologna, Via Montericco 4, 40026 Imola, BO, ItalyEndoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and stone extraction is the treatment of choice for choledocholithiasis, reaching a successful clearance of the common bile duct (CBD) in up to 90% of the cases. Endoscopic ultrasound (EUS) has the best diagnostic accuracy for CBD stones, its sensitivity and specificity range being 89–94% and 94–95%, respectively. Traditionally seen as two separate entities, the two worlds of EUS and ERCP have recently come together under the new discipline of bilio-pancreatic endoscopy. Nevertheless, the complexity of both EUS and ERCP led the European Society of Gastrointestinal Endoscopy to identify quality in endoscopy as a top priority in its recent EUS and ERCP curriculum recommendations. The clinical benefits of performing EUS and ERCP in the same session are several, such as benefiting from real-time information from EUS, having one single sedation for both the diagnosis and the treatment of biliary stones, reducing the risk of cholangitis/acute pancreatitis while waiting for ERCP after the EUS diagnosis, and ultimately shortening the hospital stay and costs while preserving patients’ outcomes. Potential candidates for the same session approach include patients at high risk for CBD stones, symptomatic individuals with status post-cholecystectomy, pregnant women, and those unfit for surgery. This narrative review discusses the main technical aspects and evidence from the literature about EUS and ERCP in the management of choledocholithiasis.https://www.mdpi.com/1648-9144/57/10/1019endosonographyEUSERCPcholedocholithiasisbiliary stonessame session |
| spellingShingle | Pietro Fusaroli Andrea Lisotti EUS and ERCP in the Same Session for Biliary Stones: From Risk Stratification to Treatment Strategy in Different Clinical Conditions Medicina endosonography EUS ERCP choledocholithiasis biliary stones same session |
| title | EUS and ERCP in the Same Session for Biliary Stones: From Risk Stratification to Treatment Strategy in Different Clinical Conditions |
| title_full | EUS and ERCP in the Same Session for Biliary Stones: From Risk Stratification to Treatment Strategy in Different Clinical Conditions |
| title_fullStr | EUS and ERCP in the Same Session for Biliary Stones: From Risk Stratification to Treatment Strategy in Different Clinical Conditions |
| title_full_unstemmed | EUS and ERCP in the Same Session for Biliary Stones: From Risk Stratification to Treatment Strategy in Different Clinical Conditions |
| title_short | EUS and ERCP in the Same Session for Biliary Stones: From Risk Stratification to Treatment Strategy in Different Clinical Conditions |
| title_sort | eus and ercp in the same session for biliary stones from risk stratification to treatment strategy in different clinical conditions |
| topic | endosonography EUS ERCP choledocholithiasis biliary stones same session |
| url | https://www.mdpi.com/1648-9144/57/10/1019 |
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