Efficacy of spyglass-guided electrohydraulic lithotripsy in difficult bile duct stones

Background/Aims: We aimed to evaluate the efficacy and safety of Spyglass-guided electrohydraulic lithotripsy (EHL) for difficult common bile duct stones (CBD) not amenable to conventional endoscopic therapy. Design: A retrospective study evaluating the efficacy of Spyglass-guided EHL in treating di...

Full description

Bibliographic Details
Main Authors: Abdulrahman M Aljebreen, Othman R Alharbi, Nahla Azzam, Majid A Almadi
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2014-01-01
Series:The Saudi Journal of Gastroenterology
Subjects:
Online Access:http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2014;volume=20;issue=6;spage=366;epage=370;aulast=Aljebreen
Description
Summary:Background/Aims: We aimed to evaluate the efficacy and safety of Spyglass-guided electrohydraulic lithotripsy (EHL) for difficult common bile duct stones (CBD) not amenable to conventional endoscopic therapy. Design: A retrospective study evaluating the efficacy of Spyglass-guided EHL in treating difficult CBD stones, in a single tertiary care center. Patients and Methods: All patients who underwent Spyglass-guided EHL from 2012 to 2013 were compared with a historical cohort who had ECSWL. Results: A total number of 13 patients underwent Spyglass-guided EHL, 8 (61.5%) of them were males. The mean age was 46.5 ± 5.6 years. Bile duct clearance was achieved in 13 (100%) of them. Seventy-six percent required only one Endoscopic Retrograde Cholangiopancreatography (ERCP) to clear the CBD, 7.7% required two ERCPs, and 15.4% required three ERCPs. Adverse effects (cholangitis) occurred in one patient (10%), whereas only 30 patients (64.4%) of the ESWL group had complete CBD stone clearance. Thirty-seven percent required one ERCP to clear the CBD, 35.6% required two ERCPs, and 20% required three ERCPs. Adverse effects happened in seven (15.5%) patients, where five (11%) had cholangitis and two (4.4%) had pancreatitis. Conclusion: Although a retrospective design with a small sample size, we concluded that Spyglass-guided EHL is an effective procedure in treating difficult CBD stones.
ISSN:1319-3767
1998-4049