Clinical Practice KPBA Guideline for Common Bile Duct Stones: The Endoscopic Management of Difficult and Recurrent Common Bile Duct Stones
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1 PBS-I Pancreatobiliary Endoscopist's Rule of Thumb Clinical Practice KPBA Guideline for Common Bile Duct Stones: The Endoscopic Management of Difficult and Recurrent Common Bile Duct Stones Byung Moo Yoo, M.D., Ph.D. Ajou University School of Medicine, Korea Introduction ERCP with EST has been conventional treatment modality for the treatment of common bile duct (CBD) stone. By this conventional treatment modality, successful treatment of CBD stones are possible in 85-90% of patients. 1, 2 However, in 10-15%of patients, complete removal of CBD stones are impossible due to number, size and shape of stones, the degree of bending of distal CBD, ble duct stenosis, and anatomical alteration due to surgery etc. Generally, CBD stones which was recurred before 6 months after complete removal of stones are remnant CBD stones, and after 6 months are recurred CBD stones. 3 The recurrence rate of CBD stones were reported about 3-15%. 2-5 Risk factors of recurred CBD stones were gallbladder stones, mechanical lithotripsy, dilatation of CBD (more than 15mm in diameter), periampullary diverticulum, bending of CBD, stasis of bile juice, stenosis of bile duct, stenosis of ampulla, and hemolytic anemia. In KPBA, recommended guideline for the difficult or recurrent CBD stones based on the America and Europe guidelines. 6, 7 1. Management of difficult bile duct stones 1) Huge bile duct stones (1) Mechanical lithotripsy Recommended for the first line therapy for the huge CBD stones smaller than 3cm which was difficult to remove with conventional treatment modality (basket or balloon catheter after sphincterotomy) : evidence and recommendation 1B Mechanical lithotripsy is a very useful basic endoscopic skill, especially in case of huge CBD stone which cannot be removed by conventional method. 6 The success rate of mechanical lithotripsy was 79-92% Main causes of failure of mechanical lithotripsy are impaction of CBD stones in bile duct and the size of stones. If the diameter of the stones are larger than 3cm, it is difficult to grasp the stone with basket. Therefore, applied the me th KJSGE
2 PBS-I: Pancreatobiliary Endoscopist's Rule of Thumb chanical lithotripsy in the diameter of stones are less than 3cm. 11 (2) Electrohydraulic lithotripsy (EHL) or laser lithotripsy (LL) Recommended treatment modality under choledochoscopy, in huge CBD stones which was difficult to remove with conventional method: evidence and recommendation 1B EHL or LLS are fragmentation of stone by contact the probe directly to the stones. Especially, EHL or LL are useful in impacted CBD stones. Usually, the success rate of EHL and LL were 74-95% and 88-97%, respectively. 2, For LL, FREDDY (Frequency Doubled Double Pulse YAG Laser) system or holmium laser systems were usually used. FREDDY system has advantage that it does not injure the human tissue. 20 The complication rate of EHL or LL was 3-19%. The common complications are cholangitis and bleeding Usually, mother-baby scope system had been used for EHL or LL. However, this system had disadvantages such as need two expert endoscopist and easily fragile baby scope system. Therefore, nowadays SpyGlass Direct Visualization System (Bosto Scientific Corp. Natick, MA, USA) or direct peroral cholangioscope with ultra-slim endoscope can be used for EHL or LL If fail to approach with ERCP, EHL or LL with percutaneous transhepatic choledochoscopy is a kind of alternative therapeutic modality. (3) Endoscopic papillary large balloon dilatation (EPLBD) Recommended in patients without distal CBD stricture in huge CBD stones which was difficult to remove with conventional method: evidence and recommendation 1B In 2003, Ersoz et al report about the usefulness of EPLBD after endoscopic sphincterotomy. EPLBD has been reported as an effective therapeutic modality for the difficult CBD stones The successful complete removal rate of huge CBD stones with EPLBD has been reported % and the complication rate of EPLBD was 0-16% EPLBD should be performed in patients without distal bile duct stricture to prevent the perforation. And limited EST was enough before EPLBD. (4) Temporal endoscopic biliary stenting Recommended in old age or high operation risk patients with huge CBD stones which was difficult to remove with conventional method. Temporal endoscopic biliary stenting increase secondary endoscopic success rate of removal of CBD stones.: evidence and recommendation 2B Although, temporal biliary stenting was not a established therapy for CBD stones, the procedure is relatively simple and easy, and through the stenting drain the infected bile and prevent the impaction of CBD stones. In some reports, the size of CBD stones decreased after biliary stenting because of friction between the stent and stones. Therefore, it makes easy to remove the CBD stones Indications for temporal biliary stenting for CBD stones were huge CBD stones (diameter >15mm), old age, and high surgical risk patients. The successful 14 th KJSGE 103
3 14 th KJSGE stone complete CBD stone removal rate after temporal biliary stenting was 44-92% Although there was no confirmation data about the duration of temporal biliary stenting, usually recommend 3 months to prevent stent induced ascending cholangitis. 32 1) Altered anatomy after surgery Consult to the practiced expert or send to the upper grade hospital in patients with Billroth II or Roun-en-Y anastomosis.: evidence and recommendation rate 1C If fail to successful removal of CBD stones in patients with Billroth II or Roun-en-Y anastomosis, percutaneous transhepatic choledochoscopic lithotripsy is useful treatment modality: evidence and recommendation 1B For the successful CBD stone removal, selective cannulation of bile duct during ERCP is essential. However, after surgery such as Billroth-II or Roux-en-Y anastomosis, the successful selective cannulation rate was lower compare to normal. In such patients, there was difficulties in both approach to the ampulla and selective cannulation of bile duct because of altered anatomy. Especially, after Roux-en-Y anastomosis the selective cannulation rate were lower than Billroth-II anastomosis. 33,34 And also the complication rate increased in patient with altered anatomy Percutaneous transhepatic approach has disadvantages such as it takes long time and more invasive compare to ERCP. However, percutaneous approached could be applied in patients with failed ERCP. 38,39 2. Management of recurrent bile duct stones 1) Recurrent ERCP Recurrent ERCP can be used as first line treatment modality for the recurrent CBD stones after ERCP.: evidence and recommendation 1C The successful complete stone removal rate by ERCP is very high in recurrent CBD stones ERCP for the recurrent CBD stones were usually safe because in these patient EST were performed previously. However, it is difficult to fix the causes of recurrent CBD stone, such as marked dilated bile duct (>15mm) or periampullary diverticulum. Geenen et al recommend surveillance ERC every year to prevent the recurrent cholangitis in patients with recurrent CBD stones. 43 However, need more randomized controlled study to get the conformational result. Conclusion For the patients with huge CBD stones who fail to remove CBD stones with conventional ERCP, mechanical lithotripsy, laser lithotripsy, eletrohydraulic litripsy, EPLBD, and temporal biliary stenting could be applied. Percutaneous transhepatic approach is a useful alternative treatment modality for the patients altered anatomy due to surgery. And ERCP is a very safe treatment modality for the patients with recurrent CBD stones th KJSGE
4 PBS-I: Pancreatobiliary Endoscopist's Rule of Thumb References 1. Cotton PB. Non-operative removal of bile duct stones by duodenoscopic sphincterotomy. Br J Surg 1980;67: Binmoeller KF, Bruckner M, Thonke F, et al. Treatment of difficult bile duct stones using mechanical, electrohydraulic and extracorporeal shock wave lithotripsy. Endoscopy 1993;25: Keizman D, Shalom MI, Konikoff FM. An angulated common bile duct predisposes to recurrent symptomatic bile duct stones after endoscopic stone extraction. Surg Endosc 2006;20: Hawes RH, Cotton PB, Vallon AG. Follow-up 6 to 11 years after duodenoscopic sphincterotomy for stones in patients with prior cholecystectomy. Gastroenterology 1990;98: Prat F, Malak NA, Pelletier G, et al. Biliary symptoms and complications more than 8 years after endoscopic sphincterotomy for choledocholithiasis. Gastroenterology 1996;110: Williams EJ, Green J, Beckingham I, et al. Guidelines on the management of common bile duct stones (CBDS). Gut 2008;57: Committee ASoP, Maple JT, Ikenberry SO, et al. The role of endoscopy in the management of choledocholithiasis. Gastrointest Endosc 2011;74: Shaw MJ, Mackie RD, Moore JP, et al. Results of a multicenter trial using a mechanical lithotripter for the treatment of large bile duct stones. Am J Gastroenterol 1993;88: Vij JC, Jain M, Rawal KK, et al. Endoscopic management of large bile duct stones by mechanical lithotripsy. Indian J Gastroenterol 1995;14: Garg PK, Tandon RK, Ahuja V, et al. Predictors of unsuccessful mechanical lithotripsy and endoscopic clearance of large bile duct stones. Gastrointest Endosc 2004;59: Chang WH, Chu CH, Wang TE, et al. Outcome of simple use of mechanical lithotripsy of difficult common bile duct stones. World J Gastroenterol 2005;11: Adamek HE, Maier M, Jakobs R, et al. Management of retained bile duct stones: a prospective open trial comparing extracorporeal and intracorporeal lithotripsy. Gastrointest Endosc 1996;44: Arya N, Nelles SE, Haber GB, et al. Electrohydraulic lithotripsy in 111 patients: a safe and effective therapy for difficult bile duct stones. Am J Gastroenterol 2004;99: Swahn F, Edlund G, Enochsson L, et al. Ten years of Swedish experience with intraductal electrohydraulic lithotripsy and laser lithotripsy for the treatment of difficult bile duct stones: an effective and safe option for octogenarians. Surg Endosc 2010;24: Hui CK, Lai KC, Ng M, et al. Retained common bile duct stones: a comparison between biliary stenting and complete clearance of stones by electrohydraulic lithotripsy. Aliment Pharmacol Ther 2003;17: Neuhaus H, Hoffmann W, Gottlieb K, et al. Endoscopic lithotripsy of bile duct stones using a new laser with automatic stone recognition. Gastrointest Endosc 1994;40: Neuhaus H, Zillinger C, Born P, et al. Randomized study of intracorporeal laser lithotripsy versus extracorporeal shock-wave lithotripsy for difficult bile duct stones. Gastrointest Endosc 1998;47: Prat F, Fritsch J, Choury AD, et al. Laser lithotripsy of difficult biliary stones. Gastrointest Endosc 1994;40: Schreiber F, Gurakuqi GC, Trauner M. Endoscopic intracorporeal laser lithotripsy of difficult common bile duct stones with a stone-recognition pulsed dye laser system. Gastrointest Endosc 1995;42: Kim TH, Oh HJ, Choi CS, et al. Clinical usefulness of transpapillary removal of common bile duct stones by frequency doubled double pulse Nd:YAG laser. World J Gastroenterol 2008;14: Maydeo A, Kwek BE, Bhandari S, et al. Single-operator cholangioscopy-guided laser lithotripsy in patients with difficult biliary and pancreatic ductal stones (with videos). Gastrointest Endosc 2011;74: Moon JH, Choi HJ, Ko BM. Therapeutic role of direct peroral cholangioscopy using an ultra-slim upper endoscope. J 14 th KJSGE 105
5 14 th KJSGE Hepatobiliary Pancreat Sci 2011;18: Moon JH, Ko BM, Choi HJ, et al. Direct peroral cholangioscopy using an ultra-slim upper endoscope for the treatment of retained bile duct stones. Am J Gastroenterol 2009;104: Heo JH, Kang DH, Jung HJ, et al. Endoscopic sphincterotomy plus large-balloon dilation versus endoscopic sphincterotomy for removal of bile-duct stones. Gastrointest Endosc 2007;66: ; quiz 768, Maydeo A, Bhandari S. Balloon sphincteroplasty for removing difficult bile duct stones. Endoscopy 2007;39: Minami A, Hirose S, Nomoto T, et al. Small sphincterotomy combined with papillary dilation with large balloon permits retrieval of large stones without mechanical lithotripsy. World J Gastroenterol 2007;13: Cotton PB. Endoscopic management of bile duct stones; (apples and oranges). Gut 1984;25: Cotton PB, Forbes A, Leung JW, et al. Endoscopic stenting for long-term treatment of large bile duct stones: 2- to 5-year follow-up. Gastrointest Endosc 1987;33: Siegel JH, Yatto RP. Biliary endoprostheses for the management of retained common bile duct stones. Am J Gastroenterol 1984;79: Chan AC, Ng EK, Chung SC, et al. Common bile duct stones become smaller after endoscopic biliary stenting. Endoscopy 1998;30: Peters R, Macmathuna P, Lombard M, et al. Management of common bile duct stones with a biliary endoprosthesis. Report on 40 cases. Gut 1992;33: Dumonceau JM, Tringali A, Blero D, et al. Biliary stenting: indications, choice of stents and results: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy 2012;44: Hintze RE, Adler A, Veltzke W, et al. Endoscopic access to the papilla of Vater for endoscopic retrograde cholangiopancreatography in patients with billroth II or Roux-en-Y gastrojejunostomy. Endoscopy 1997;29: Wright BE, Cass OW, Freeman ML. ERCP in patients with long-limb Roux-en-Y gastrojejunostomy and intact papilla. Gastrointest Endosc 2002;56: Bergman JJ, van Berkel AM, Bruno MJ, et al. A randomized trial of endoscopic balloon dilation and endoscopic sphincterotomy for removal of bile duct stones in patients with a prior Billroth II gastrectomy. Gastrointest Endosc 2001;53: Faylona JM, Qadir A, Chan AC, et al. Small-bowel perforations related to endoscopic retrograde cholangiopancreatography (ERCP) in patients with Billroth II gastrectomy. Endoscopy 1999;31: Loperfido S, Angelini G, Benedetti G, et al. Major early complications from diagnostic and therapeutic ERCP: a prospective multicenter study. Gastrointest Endosc 1998;48: Jeong EJ, Kang DH, Kim DU, et al. Percutaneous transhepatic choledochoscopic lithotomy as a rescue therapy for removal of bile duct stones in Billroth II gastrectomy patients who are difficult to perform ERCP. Eur J Gastroenterol Hepatol 2009;21: Rimon U, Kleinmann N, Bensaid P, et al. Percutaneous transhepatic endoscopic holmium laser lithotripsy for intrahepatic and choledochal biliary stones. Cardiovasc Intervent Radiol 2011;34: Cariati A, Cetta F. Re: Kawai et al.--bacteria are not important in the formation of pure cholesterol stones. Am J Gastroenterol 2002;97:2921-2; author reply Lai KH, Peng NJ, Lo GH, et al. Prediction of recurrent choledocholithiasis by quantitative cholescintigraphy in patients after endoscopic sphincterotomy. Gut 1997;41: Sugiyama M, Atomi Y. Risk factors predictive of late complications after endoscopic sphincterotomy for bile duct stones: long-term (more than 10 years) follow-up study. Am J Gastroenterol 2002;97: Geenen DJ, Geenen JE, Jafri FM, et al. The role of surveillance endoscopic retrograde cholangiopancreatography in preventing episodic cholangitis in patients with recurrent common bile duct stones. Endoscopy 1998;30: th KJSGE
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