Efficacy of Common Bile Duct Stenting on the Reduction in Gallstone Migration and Symptoms Recurrence in Patients with Biliary Pancreatitis Who Were Candidates for Delayed Cholecystectomy

Dig Dis Sci. 2022 Jan;67(1):315-320. doi: 10.1007/s10620-021-06904-8. Epub 2021 Mar 20.

Abstract

Background: In patients with severe biliary pancreatitis, delayed cholecystectomy associated with a high risk of recurrence is recommended. The current study aimed to evaluate the effect of common bile duct (CBD) stenting on reducing gallstones migration and recurrence of symptoms in patients with pancreatitis and delayed cholecystectomy candidates.

Methods: To this purpose, the randomized, controlled clinical trial was performed on 40 patients with biliary pancreatitis who were candidates for delayed cholecystectomy. Patients were randomly divided into two groups of A and B that underwent CBD stenting after ERCP and received endoscopic treatment without stenting, respectively. A checklist recorded demographics and complications. Group A was followed up after four weeks to remove the stent and record the complications. Group B underwent MRCP to examine the migration of new gallstones as well as the complications.

Results: Of the 40 patients, 20 subjects (11 males and 9 females) were allocated to each group, matched for demographic variables. In the one-month follow-up, only one subject in group A manifested symptoms of gallstone migration and recurrence, while in group B, recurrence was observed in 6 patients (P = 0.037). There was no significant difference in the success rate of ERCP and the incidence of complications between the two groups.

Conclusion: CBD stenting in patients with biliary pancreatitis and gallstone could reduce the risk of recurrence and remigration of gallstones in delayed cholecystectomy cases.

Keywords: Bile Duct Gall Stones; Cholangiopancreatography; Cholecystectomy; Cholecystitis; Endoscopic; Pancreatitis; Retrograde; Stents.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Cholangiopancreatography, Endoscopic Retrograde* / adverse effects
  • Cholangiopancreatography, Endoscopic Retrograde* / instrumentation
  • Cholangiopancreatography, Endoscopic Retrograde* / methods
  • Cholecystectomy / methods*
  • Female
  • Gallstones* / complications
  • Gallstones* / diagnosis
  • Gallstones* / physiopathology
  • Gallstones* / surgery
  • Humans
  • Male
  • Middle Aged
  • Pancreatitis* / diagnosis
  • Pancreatitis* / etiology
  • Pancreatitis* / prevention & control
  • Postoperative Complications* / diagnosis
  • Postoperative Complications* / etiology
  • Postoperative Complications* / prevention & control
  • Prosthesis Implantation* / adverse effects
  • Prosthesis Implantation* / instrumentation
  • Prosthesis Implantation* / methods
  • Risk Adjustment / methods
  • Secondary Prevention / methods
  • Stents
  • Time-to-Treatment
  • Treatment Outcome