Success Rate of Common Bile Duct Stones Extraction on First ERCP Attempt

Abstract

Objective: To determine the success rate of common bile duct stones extraction on first endoscopic retrograde cholangiopancreatography (ERCP) attempt among patients with suspected choledocholithiasis.

Methods: This retrospective study was performed from January 2012 till December 2015. All patients diagnosed with choledocholithiasis on the basis of sonographic or other radiological evidence of Common Bile Duct stones or patients who had cholestatic liver functions on the background of gallstones were included. Data were retrieved from the endoscopic database.

Results: Out of 612 patients with suspected choledocholithiasis, stones were found on ERCP in 592 patients (96.75%). During the first attempt at ERCP, 480 patients out of 592 had complete duct clearance (81.08%). The percentage of stones cleared via balloon was 434 (90.42%) and via basket was 46 (9.58%). The plastic stent was placed in remaining 112 patients (18.30%) that were kept on the list for follow up ERCP. A total of 44 patients out of 592 underwent sphincteroplasty (7.4%), in which 32 patients had complete duct clearance (72.72%), whereas 12 patients have stent placement (27.27%). Complete duct clearance on first ERCP attempt was found significantly associated with age (p-value 0.011) and stone diameter (p-value <0.001).

Conclusion: In our experience, at first ERCP attempt, the stone extraction rate is around 81.08%. This relates to the expertise in doing ERCP. The size and shape of stone and size of Bile duct are the predominant reason behind the failure of stone extraction on first ERCP attempt.