Retrospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 21, 2018; 24(39): 4489-4498
Published online Oct 21, 2018. doi: 10.3748/wjg.v24.i39.4489
Ursodeoxycholic acid combined with percutaneous transhepatic balloon dilation for management of gallstones after elimination of common bile duct stones
Hai-Yang Chang, Chang-Jun Wang, Bin Liu, Yong-Zheng Wang, Wu-Jie Wang, Wei Wang, Dong Li, Yu-Liang Li
Hai-Yang Chang, Bin Liu, Yong-Zheng Wang, Wu-Jie Wang, Wei Wang, Dong Li, Yu-Liang Li, Department of Intervention Medicine, the Second Hospital of Shandong University, Jinan 250033, Shandong Province, China
Hai-Yang Chang, Bin Liu, Yong-Zheng Wang, Wu-Jie Wang, Wei Wang, Dong Li, Yu-Liang Li, Interventional Oncology Institute, Shandong University, Jinan 250033, Shandong Province, China
Chang-Jun Wang, Department of Radiology, Jiyang People’s Hospital, Jinan 251400, Shandong Province, China
Author contributions: All authors helped to perform the research; Chang HY contributed to manuscript writing, statistical analysis, and manuscript critical revision; Li YL contributed to study conception and design, manuscript writing, statistical analysis, and manuscript critical revision; Wang CJ, Liu B, Wang YZ, Wang WJ, Wang W, and Li D contributed to manuscript writing.
Supported by the Natural Science Foundation of Shandong Province, No. ZR2014HM050; the Youth Foundation of the Second Hospital of Shandong University, No. Y2014010047; the Nature Science Foundation of Shandong Province, No. ZR2018PH032 and No. ZR2018PH033; and the National Natural Science Foundation of China, No. 61671276.
Institutional review board statement: This study was reviewed and approved by the ethics committee of the Second Hospital of Shandong University.
Informed consent statement: All participants provided written informed consent.
Conflict-of-interest statement: All authors declare no conflicts of interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yu-Liang Li, MD, PhD, Chief Doctor, Doctor, Professor, Department of Intervention Medicine, The Second Hospital of Shandong University, 247 Beiyuan Road, Jinan 250033, Shangdong Province, China. lyl.pro@sdu.edu.cn
Telephone: +86-531-85875927
Received: July 25, 2018
Peer-review started: July 25, 2018
First decision: August 27, 2018
Revised: August 29, 2018
Accepted: October 5, 2018
Article in press: October 5, 2018
Published online: October 21, 2018
Processing time: 85 Days and 2.9 Hours
ARTICLE HIGHLIGHTS
Research background

Bile duct stones are the most frequent cause of benign bile duct disease. The choice of management of common bile duct (CBD) stones includes surgical exploration, endoscopic intervention and percutaneous transhepatic intervention. Subsequent cholecystectomy is the first choice to prevent the recurrence of stones for patients with concomitant CBD stones and gallstones. This retrospective study aimed to evaluate the clinical efficacy and safety of ursodeoxycholic acid combined with percutaneous transhepatic balloon dilation for management of gallstones after elimination of CBD Stones.

Research motivation

Percutaneous transhepatic intervention served as an effective option for management of CBD stones in the past decades. The preferable choice of management for patients with concomitant CBD stones and gallstones is controversial.

Research objectives

The retrospective study evaluated the effectiveness and safety of a novel technique for management of gallstones after expulsion of CBD stones in terms of technical success and postoperative complications.

Research methods

Fifteen consecutive patients diagnosed with concomitant CBD stones and gallstones were evaluated. All patients underwent application of ursodeoxycholic acid combined with percutaneous transhepatic balloon dilation for management of gallstones after elimination of CBD stones. Clinical assessment, physical examination, laboratory tests and imaging were assessed in all patients. All statistics analyses were performed using SPSS 24.0. P-values < 0.05 were defined as statistically difference for all data.

Research results

The novel technique was successful in 86.7% of patients with concomitant CBD stones and gallstones with few postoperative complications treated successfully via nonsurgical management. It seems to be an alternative to open or laparoscopic surgery and endoscopic intervention.

Research conclusions

The present study showed that ursodeoxycholic acid combined with percutaneous transhepatic balloon dilation was secure and feasible for management of gallstones after elimination of CBD stones, especially for patients with good gallbladder contraction function, diameter of gallstone no greater than 12 mm, and dilation of the cystic duct. It also provides an alternative when operative management is not available for patients in poor condition.

Research perspectives

In case of therapeutic failure, good gallbladder contraction function or dilation of the cystic duct was not observed. However, the diameters of stones in failed cases were much greater than those of successful cases. This novel technique provides a feasible option for patients with concomitant gallstones and CBD stones. Prospective studies are needed for further confirmation.