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2012, Number 4

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Rev Cub Med Mil 2012; 41 (4)

Usefulness of endoscopic retrograde cholangiopancreatography to treat main bile duct lithiasis

Ramos CJY, Martínez LL, Infante VM, de la Rosa OM, Almenares GZ, Brizuela QR

Language: Spanish
References: 29
Page: 361-369
PDF size: 80.44 Kb.


ABSTRACT

Introduction: lithiasis of the main bile duct is one of the main indications for endoscopic retrograde cholangiopancreatography (ERCP). This procedure can remove stones using a minimally invasive procedure.
Objective: to determine the usefulness of cholangiopancreatography in the treatment of choledocholithiasis.
Methods: a retrospective and descriptive study of the results of cholangiopancreatography performed in patients with lithiasis of the main bile duct from 2009 and 2010. The sample was 31 patients. Percentages, mean and standard deviation were used to compile the information. Technical procedures were performed to determine the predictive ability of ultrasound and alkaline phosphatase in the diagnosis of choledocholithiasis.
Results: most patients were female. A high percentage were older than 60 years and some were older than 90. Stone removal was achieved in 60.8 %. The ultrasound showed 51.61 % of sensitivity (95 % CI 32.41 to 70.82) and 88.98 % of specificity (CI 83.14 to 94.82) for the diagnosis of urolithiasis. Alkaline phosphatase showed no diagnostic accuracy (AUC = 0.501).
Conclusions: results support the utility of endoscopic retrograde cholangiopancreatography for choledocholithiasis treatment. The predictive ability of ultrasound and alkaline phosphatase was low, if compared with the results of this procedure.


REFERENCES

  1. Safrany L. Endoscopic treatment of biliary-tract disease. Lancet. 1978 2:983.

  2. Sheridan WG, Williams HO, Lewis MH. Morbidity and mortality of common bile duct exploration. Br J Surg. 1987;74(12):1095-9.

  3. Edison SA, Maier M, Kohler B, Schlauch D, Buttmann A, Gauer E, et al. Direct dissolution of gallstones with methyl tert-butyl ether by endoscopic cannulation of the gallbladder. Am J Gastroenterol. 1993;88(8):1242-8.

  4. Kawai K, Akasaka Y, Murakami K, Tada M, Koli Y. Endoscopic sphincterotomy of the ampulla of Vater. Gastrointest Endosc. 1974;20(4):148-51.

  5. Ruiz Torres J, Brizuela Quintanilla RA, Martínez López R, Díaz-Canel Fernández O, Pernia González L. Colangiopancreatografía retrógrada endoscópica: experiencia de 14 años en un centro de concentración de alta especialidad. Endoscopia. 2009;21(4):27-31.

  6. Brizuela R, Fábregas C, Arús E, Franco S. La colangiopancreatografía retrógrada endoscópica: experiencia en 302 casos. Rev Cubana Cir. 1988;27(6):37-42.

  7. Ramos Pachón C, González Cansino J, Fernández Maderos I, Samada Suárez M. Diagnóstico de la coledocolitiasis y resultados de su terapéutica mediante colangiopancreatografía retrógrada endoscópica. Investigaciones Medicoquirúrgicas. 2009;1(2):41-8.

  8. Vázquez onzález P, Osorio agola M, Becerra erón G, González érez M, Barrios uentes P, Monzón ega D. Dificultad técnica y éxito de la colecistopancreatografía retrógrada endoscópica en un grupo de pacientes. MediSur. 2010;8(2):23-30.

  9. Benavides OE, Cruz EP, Marun CM, Hernández MM. Prevalence of periampullary diverticular, its association with choledocolithiasis and technical sucess with ERCP. Rev Gastroenterol Mex. 2006;71(4):473-7.

  10. Yriberry Urena S, Salazar Muente F, Monge Zapata V, Prochazka Zarate R, Vila Gutiérrez S, Barriga Briceno JA, et al. Expected and unexpected adverse events in the therapeutic endoscopy of the bile duct (ERCP): experience of a private national center in 1356 consecutive cases (1999-2008)]. Rev Gastroenterol Peru. 2009;29(4):311-20.

  11. Rabago L, Guerra I, Morán M, Quintanilla E, Collado D, Chico I, et al. Is outpatient ERCP suitable, feasible, and safe? The experience of a Spanish community hospital. Surg Endosc. 2010;24(7):1701-6.

  12. Dundee PE, Chin-Lenn L, Syme DB, Thomas PR. Outcomes of ERCP: prospective series from a rural centre. ANZ J Surg. 2007;77(11):1013-17.

  13. Ali M, Ward G, Staley D, Duerksen DR. A Retrospective Study of the Safety and Efficacy of ERCP in Octogenarians. Dig Dis Sci. 2010 [citado 22 Ago 2011]. Disponible en: http://www.springerlink.com/content/d146438344318h68/?MUD=MP

  14. Lukens FJ, Howell DA, Upender S, Sheth SG, Jafri SM. ERCP in the very elderly: outcomes among patients older than eighty. Dig Dis Sci. 2010;55(3):847-51.

  15. Benson ME, Byrne S, Brust DJ, Manning B, Pfau PR, Frick TJ, et al. EUS and ERCP Complication Rates Are Not Increased in Elderly Patients. Dig Dis Sci. 2010 [citado 22 Ago 2011]. Disponible en: http://www.researchgate.net/publication/41579170_EUS_and_ERCP_complication_rates_are_not_increased_inelderly_patients

  16. Lukens FJ, Howell DA, Upender S, Sheth SG, Jafri SM. ERCP in the very elderly: outcomes among patients older than eighty. Dig Dis Sci. 2010;55(3):847-51.

  17. Gronroos JM, Salminen P, Laine S, Gullichsen R. Feasibility of ERCP procedures in patients 90 years of age and older. J Clin Gastroenterol. 2010;44(3):227-8.

  18. García-Cano J, González Martín JA, Morillas Arino MJ, Pérez García JI, Redondo Cerezo E, Jimeno Ayllon C, et al. Outcomes of bile duct drainage by means of ERCP in geriatric patients. Rev Española Enferm Dig. 2007;99(8):451-6.

  19. Baron TH, Harewood GC. Endoscopic balloon dilation of the biliary sphincter compared to endoscopic biliary sphincterotomy for removal of common bile duct stones during ERCP: a metanalysis of randomized, controlled trials. Am J Gastroenterol. 2004;99(8):1455-60.

  20. May GR, Cotton PB, Edmunds SE, Chong W. Removal of stones from the bile duct at ERCP without sphincterotomy. Gastrointest Endosc. 1993;39(6):749-54.

  21. Cohello R, Bordas JM, Guevara MC, Liach J, Mondelo F, Gines A, et al. Litotricia mecánica durante la CPRE en la coledocolitiasis intratable mediante esfinterotomía convencional. Gastroenterol Hepatol. 1997;20(3):124-7.

  22. Gómez Ponce RL. Complicaciones precoces de las CPRE realizadas desde enero de 1998 hasta diciembre del 2000 en el Hospital Nacional Daniel Alcides Carrión, "El Callao", Perú. Rev Gastroenterol Perú. 2002;22(1):33-43.

  23. García-Cano J. Biliary and pancreatic drainage after ERCP for choledocholithiasis. J Hepatobiliary Pancreat Surg. 2003;10(4):329-31.

  24. Espinosa-Torres L, Torices-Escalante E, Zavala-Vivanco E. Manejo Endoscópico de la Coledocolitiasis. Rev Endosc. 2000;11(1):21-4.

  25. Gómez-Cárdenas X, Pérez-Burquete B, Rendón-Castillo E. Tratamiento endoscópico de la litiasis residual. Rev Mexicana Cir Endosc. 2003;4:178-83.

  26. Santucci L, Natalini G, Sarpi L, Fiorucci S, Solinas A, Morelli A. Selective endoscopic retrograde cholangiography and preoperative bile duct stone removal in patients scheduled for laparoscopic cholecystectomy: a prospective study. Am J Gastroenterol. 1996;91(7):1326-30.

  27. Bejerano-Castro M. Utilidad de los factores predictores de coledocolitiasis en pacientes operados en la Clínica Rafael Uribe Uribe-Cali. Rev Cirugía. 2000;18(2):73-83.

  28. Hoyuela C, Cugat E, Veloso E, Marco C. Opciones actuales para el diagnóstico y tratamiento de la coledocolitiasis. Cir Esp. 2000;68:243-53.

  29. Yriberry Urena S, Monge Zapa V. Alteraciones en las pruebas de laboratorio como predictores de coledocolitiasis en pacientes a quienes se les realiza CPRE: experiencias de un centro nacional privado. Rev Gastroenterol Perú. 2007; 27(3):253-8.




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