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National Survey Regarding the Management of Difficult Bile Duct Stones in South Korea.

Authors :
Lee YS
Jeon TJ
Paik WH
Ahn DW
Chung KH
Son BK
Song TJ
Moon SH
Lee ES
Lee JM
Yoon SB
Paik CN
Lee YN
Park JS
Lee DW
Park SW
Chon HK
Cho KB
Park CH
Source :
Gut and liver [Gut Liver] 2023 May 15; Vol. 17 (3), pp. 475-481. Date of Electronic Publication: 2022 Jul 19.
Publication Year :
2023

Abstract

Background/aims: This study aimed to investigate the patterns of preferred endoscopic procedure types and techniques for managing difficult common bile duct (CBD) stones in South Korea.<br />Methods: The Committee of Policy and Quality Management of Korean Pancreatobiliary Association (KPBA) conducted a survey containing 19 questions. Both paper and online surveys were carried out; with the paper survey being conducted during the 2019 Annual Congress of KPBA and the online survey being conducted through Google Forms from April 2020 to February 2021.<br />Results: The response rate was approximately 41.3% (86/208). Sixty-two (73.0%) worked at tertiary hospitals or academic medical centers, and 60 (69.7%) had more than 5 years of endoscopic retrograde cholangiopancreatography experience. The preferred size criteria for large CBD stones were 15 mm (40.6%), 20 mm (31.3%), and 30 mm (4.6%). For managing of large CBD stones, endoscopic papillary large balloon dilation after endoscopic sphincterotomy was the most preferred technique (74.4%). When performing procedures in those with bleeding diathesis, 64 (74.4%) respondents favored endoscopic papillary balloon dilation (EPBD) alone or EPBD with small endoscopic sphincterotomy. Fifty-five respondents (63.9%) preferred the doubleguidewire technique when faced with difficult bile duct cannulation in patients with periampullary diverticulum. In surgically altered anatomies, cap-fitted forward viewing endoscopy (76.7%) and percutaneous transhepatic cholangioscopy (48.8%) were the preferred techniques for Billroth-II anastomosis and total gastrectomy with Roux-en-Y anastomosis, respectively.<br />Conclusions: Most respondents showed unifying trends for the management of difficult CBD stones. The current practice patterns could be used as basic data for clinical quality improvements in the management of difficult CBD stones.

Details

Language :
English
ISSN :
2005-1212
Volume :
17
Issue :
3
Database :
MEDLINE
Journal :
Gut and liver
Publication Type :
Academic Journal
Accession number :
35851040
Full Text :
https://doi.org/10.5009/gnl220117