Current Gallstone Treatment Methods, State of the Art
Abstract
:1. Introduction
2. Percutaneous Transhepatic Choledochoscopic Lithotripsy (PTCS)
2.1. Long-Term Methods
2.2. Short-Term Methods
2.3. Introduction of a Modified Method For PTCS
3. Endoscopic Retrograde Cholangiopancreatography (ERCP) Combined with Stone Extraction
3.1. Endoscopic Sphincterotomy (EST)
3.2. Endoscopic Balloon Dilatation of the Duodenal Papillary Sphincter (EPBD)
3.3. Limited Sphincterotomy Combined with Large-Balloon Dilation (Limited EST Plus EPLBD)
3.4. Comparison of Different Stone Removal Methods in ERCP
3.5. Introduction of a Modified Method For ERCP
4. Laparoscopic Common Bile Duct Exploration and Extraction (LCBDE)
4.1. The Transcystic (TC) Duct Approach
4.2. The Transduodenal (TD) Approach
4.3. Introduction of a Modified Method For LCBDE
5. Summary
6. Future Directions
7. Conclusions
8. Advantages
9. Limitations
Author Contributions
Funding
Conflicts of Interest
Abbreviations
References
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Year | Participants (n) | Gender (M/F) | Age (Average) | Complete Stone Removal in First Session | Stone Size (Mean) | Endoscopic Sphincterotomy | Balloon Dilation Time | Post-ERCP Pancreatitis | Recommendation |
---|---|---|---|---|---|---|---|---|---|
1997 [38] | 101 | 43/58 | 72 (29–98) | 81% | 10.0 mm | 0 mm | 45–60 s | 6.9% | Preserving biliary-sphincter function following EBD may prevent long-term complications. |
101 | 45/56 | 71 (29–96) | 92% | 9.0 mm | Free passage of a fully bowed sphincterotome | 0 s | 6.9% | ||
2001 [39] | 35 | 19/16 | 69.5 (43–86) | N/A | 12.7 mm | 0 mm | 60 s | 5.7% | In most cases, EPBD results in a slight reduction in SO function; however, SO function can be preserved to a greater extent compared to EST. |
35 | 14/21 | 69.4 (43–88) | 13.6 mm | 5–10 mm | 0 s | 5.7% | |||
2004 [40] | 46 | 32/14 | 70 (40–90) | 70% | 14.0 mm | 0 mm | 60 s | 9.5% | Preserving the sphincter of Oddi function may not be essential as a selection criterion when choosing between EPBD or EST. |
45 | 30/15 | 69 (41–93) | 70% | 16.0 mm | Small Medium Large | 0 s | 8.4% | ||
2007 [41] | 90 | 51/39 | 69.1 ± 13.1 | 72.2% | 12.7 mm | 0 mm | 60 s | 16.7% | EPBD appears to be particularly useful in patients with liver cirrhosis who are prone to developing bleeding. |
90 | 49/41 | 70.2 ± 8.1 | 57.8% | 11.8 mm | 5–10 mm | 0 s | 6.7% | ||
2010 [42] | 453 | 261/192 | 60.9 ± 14.7 | N/A | 7.7 mm | N/A | 60 s | 1.7% | The combination of low-pressure EPBD with isosorbide dinitrate preserved papillary function by 70%, potentially enhancing long-term prognosis. |
233 | 104/129 | 73.3 ± 13.0 | 11.1 mm | 0 s | 0.8% | ||||
2013 [43] | 78 | 40/38 | 72.97 ± 13.42 | 88.5% | 13.26 mm | Free passage of a fully bowed sphincterotome | 0 s | 3.8% | EPBD decreased the need for ML and was less expensive. |
73 | 32/41 | 71.62 ± 14.8 | 83.3% | 12.47 mm | One-third to one-half of the size of the papilla | 30 s | 2.7% | ||
2017 [44] | 72 | 41/31 | 64.7 ± 15.9 | 83.7% | 6.0 mm | 0 mm | 60 s | 15.1% | Performing EPBD for 5 min is safe and does not increase the risk of recurrent choledocholithiasis. |
80 | 44/36 | 61.2 ± 17.4 | 95.2% | 6.3 mm | 0 mm | 300 s | 4.8% | ||
2019 [34] | 371 | 162/209 | 65 (IQR) | 97% | 10.0 mm | 3–5 mm | 0 s | 12% | The recommended approach is a balloon dilation time of 30 s combined with a small sphincterotomy. |
1549 | 753/796 | 64 (IQR) | 90% | 3–5 mm | 30, 60, 180 s | 10.0% | |||
2023 [45] | 168 | 84/84 | 70.1 ± 14.2 | 98.2% | 12.7 mm | 0 mm | 30 s | 4.8% | EPLBD alone was simple, effective, and safe compared with ES-LBD. |
57 | 20/37 | 69.6 ± 14.4 | 96.5% | 13.1 mm | One-third to one-half of the size of the papilla | 30 s | 1.8% |
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Li, X.; Ouyang, J.; Dai, J. Current Gallstone Treatment Methods, State of the Art. Diseases 2024, 12, 197. https://doi.org/10.3390/diseases12090197
Li X, Ouyang J, Dai J. Current Gallstone Treatment Methods, State of the Art. Diseases. 2024; 12(9):197. https://doi.org/10.3390/diseases12090197
Chicago/Turabian StyleLi, Xiangtian, Jun Ouyang, and Jingxing Dai. 2024. "Current Gallstone Treatment Methods, State of the Art" Diseases 12, no. 9: 197. https://doi.org/10.3390/diseases12090197