Short and Long-term outcome after endoscopic approach (EST and EPBD) for bile duct stones

Abstract

The short and long-term outcomes after the initial treatment with EST and EPBD for bile duct stones were examined. Of 206 patients initially treated for bile duct stones from 1990 to 2010, 39 post-cholecystectomy and 11 uncertain prognosis patients were excluded and 156 patients (EST: n=108, EPBD: n=48) were the subjects of this study. Treatment related pancreatitis in the EPBD group tends to be higher in the EST group (12.5% vs. 4.6%), but all these patients recovered by the conservative therapy. The recurrence rates of the bile duct stones were 10.2% (11/108) in the EST group and 6.3% (3/48) in the EPBD group without a statistical significance. The significant factors related to the recurrence of bile duct stones were the primary bile duct stones and acalculous gallbladder. The bile duct stones recurred more frequently in the patients who had not undergone simultaneous cholecystectomy than those received cholecystectomy, but the difference was not significant. These results suggest that the patients with primary bile duct stones and in those without simultaneous cholecystectomy for acalculous gallbladder should be careful follow-up after the treatment of bile duct stones.