KẾT QUẢ ĐIỀU TRỊ SỎI ĐƯỜNG MẬT CHÍNH NGOÀI GAN BẰNG NỘI SOI MẬT TỤY NGƯỢC DÒNG

Abstract

Objective: To evaluate the indications, treatment outcomes, and complications of endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis. Materials and Methods: This was a cross-sectional descriptive study conducted on 119 patients diagnosed with common bile duct stones who were hospitalized for ERCP stone extraction at Bach Mai Hospital from January 2022 to December 2022. Results: The mean age of the patients was 64 ± 16.9 years, with females being more prevalent (53.8%). A total of 7.6% of cases had anatomical variations of the stomach following surgery. The majority experienced complications of cholangitis and acute pancreatitis, accounting for 53.8% and 12.6%, respectively. Small stone size (<1 cm) was observed in 55.5% of patients, and 4 patients had stones larger than 2 cm (3.4%). Approximately one-third of cases involving common bile duct stones or common hepatic duct stones were associated with gallstones and intrahepatic bile duct stones (combined, these accounted for up to 55%). Duodenal diverticulum in DII was present in 63% of patients. ERCP outcomes showed a successful cannulation rate of 97.5%, with successful stone extraction in 101 patients. The stone clearance rate after the first intervention was 89.1%. The 100% stone clearance rate was achieved with basket extraction, 90% with intracorporeal lithotripsy, and 86% with balloon extraction. The stone clearance rate after the second intervention reached 92.3%. The cumulative stone clearance rate after two interventions was 98% (114/116). Complications included perforation in 1 patient, bleeding in 1.7%, post-procedural infection in 2.6%, and acute pancreatitis in 4.3%. Conclusion: Endoscopic retrograde cholangiopancreatography is an effective and relatively safe procedure for the treatment of extrahepatic common bile duct stones