Endoscopy 2025; 57(S 02): S366
DOI: 10.1055/s-0045-1805917
Abstracts | ESGE Days 2025
ePosters

The value of endoscopic sphincterotomy in the management of lithiasis of the main bile duct

H Aksim
1   L'hôpital militaire Avicenne, Marrakesh, Morocco
,
I Lasfar
1   L'hôpital militaire Avicenne, Marrakesh, Morocco
,
O Hadadia
1   L'hôpital militaire Avicenne, Marrakesh, Morocco
,
M Belhamdiya
1   L'hôpital militaire Avicenne, Marrakesh, Morocco
,
R Akka
1   L'hôpital militaire Avicenne, Marrakesh, Morocco
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Aims The management of main bile duct lithiasis (MBDL) has changed considerably since the introduction of endoscopic sphincterotomy (ES), which is now emerging as the treatment of choice.The aim of our work is to demonstrate the efficacy of ES in the management of main tract lithiasis, and to highlight its low complication rate [1] [2] [3] [4].

Methods We conducted a retrospective descriptive study spanning a 2-year period from December 2021 to December 2023. All patients with residual main bile duct lithiasis treated by endoscopic retrograde cholangio-pancreatography (ERCP) with ES were included. Successful ES was defined by achieving vacuity of the main bile duct. Quantitative variables were described in terms of means and standard deviations, while qualitative variables were described in terms of numbers and percentages.

Results We included 80 patients in our study, the mean age was 61 years [28-84y]. The sex ratio was 0.59 (47 women and 33 men). Of 69 patients who underwent Bili-MRI prior to surgery, lithiasis of the main bile duct was visible in 75% of cases. The mean lithiasis size was 7.3 mm [3 -17mm]. Median operative time was 48min [25min – 90min]. The success rate of endoscopic treatment was 86.6%. We noted an evacuation failure in 8.75% of patients (n=7). These patients received a plastic prosthesis. Complications numbered 10%: 6 cases of pancreatitis (7.5%), 2 cases of hemorrhage (2.5%).

Conclusions Endoscopic sphincterotomy is currently the gold standard in the management of large stones or impactions of the main bile duct.



Publication History

Article published online:
27 March 2025

© 2025. European Society of Gastrointestinal Endoscopy. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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