Saudi Journal of Gastroenterology
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Year : 2014  |  Volume : 20  |  Issue : 6  |  Page : 366-370

Efficacy of spyglass-guided electrohydraulic lithotripsy in difficult bile duct stones

1 Gastroenterology Division, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
2 Gastroenterology Division, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia; Gastroenterology Division, The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada

Correspondence Address:
Abdulrahman M Aljebreen
Department of Internal Medicine, PO Box 2925, King Khalid University Hospital, Riyadh, 11461

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1319-3767.145329

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Background/Aims: We aimed to evaluate the efficacy and safety of Spyglass-guided electrohydraulic lithotripsy (EHL) for difficult common bile duct stones (CBD) not amenable to conventional endoscopic therapy. Design: A retrospective study evaluating the efficacy of Spyglass-guided EHL in treating difficult CBD stones, in a single tertiary care center. Patients and Methods: All patients who underwent Spyglass-guided EHL from 2012 to 2013 were compared with a historical cohort who had ECSWL. Results: A total number of 13 patients underwent Spyglass-guided EHL, 8 (61.5%) of them were males. The mean age was 46.5 ± 5.6 years. Bile duct clearance was achieved in 13 (100%) of them. Seventy-six percent required only one Endoscopic Retrograde Cholangiopancreatography (ERCP) to clear the CBD, 7.7% required two ERCPs, and 15.4% required three ERCPs. Adverse effects (cholangitis) occurred in one patient (10%), whereas only 30 patients (64.4%) of the ESWL group had complete CBD stone clearance. Thirty-seven percent required one ERCP to clear the CBD, 35.6% required two ERCPs, and 20% required three ERCPs. Adverse effects happened in seven (15.5%) patients, where five (11%) had cholangitis and two (4.4%) had pancreatitis. Conclusion: Although a retrospective design with a small sample size, we concluded that Spyglass-guided EHL is an effective procedure in treating difficult CBD stones.

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