Background/Aims: Residual common bile duct (CBD) stones occasionally become symptomatic after stone removal with endoscopic retrograde cholangiopancreatography (ERCP) upon removal of the endoscopic biliary stent (EBS). An accurate evaluation of residual stones before stent removal is necessary. This study evaluated a new two-step check method using endoscopic ultrasound (EUS) for the detection of residual stones after ERCP stone removal. Methods: Fifty-six patients who underwent CBD stone removal and EBS placement were prospectively enrolled. Residual stones were evaluated by the check method. EBS was removed at the time of the check method or at a later time of residual stone removal. The primary outcome was to evaluate the efficacy of this check method. Results: Residual CBD stone/sludge was detected in 20 of 56 patients (35.7%; stones: 28.6%, sludge: 7.1%) by the check method and removed by the ERCP procedure at a later time. After stent and final stone removal, patients were followed for an average of 211 days; cholangitis recurred in only 1.8% of patients. There were no adverse events associated with the check method. Temporary EBS prevented the recurrence of cholangitis by residual stone and caused no adverse events in the pancreatobiliary tract until the two-step check method (median, 113 days; range, 17–232 days). Conclusion: The new check method may be ideal and feasible for EBS removal because recurrences are very rare when a clear CBD has been verified, and an additional ERCP procedure is also possibly avoided.
Digestion

中文翻译：

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超声内镜准确评估残余胆总管结石：残余结石清除的两步检查方法

背景/目的：在取出内镜胆管支架 (EBS) 后，通过内镜逆行胰胆管造影 (ERCP) 取出结石后，残留的胆总管 (CBD) 结石偶尔会出现症状。在移除支架之前准确评估残余结石是必要的。本研究评估了一种使用超声内镜 (EUS) 检测 ERCP 取石后残留结石的新两步检查方法。方法：前瞻性招募了 56 名接受 CBD 取石和 EBS 植入的患者。通过检查方法评估残余结石。EBS 在检查方法时或在随后的残留结石去除时被去除。主要结果是评估这种检查方法的有效性。结果：通过检查方法在 56 名患者中的 20 名（35.7%；结石：28.6%，污泥：7.1%）中检测到残留的 CBD 结石/污泥，随后通过 ERCP 程序去除。支架和最终取石后，患者平均随访 211 天；胆管炎仅在 1.8% 的患者中复发。没有与检查方法相关的不良事件。临时 EBS 通过残留结石预防胆管炎的复发，并且在两步检查方法之前没有引起胰胆道的不良事件（中位数，113 天；范围，17-232 天）。结论：新的检查方法可能是去除 EBS 的理想和可行的方法，因为当已验证明确的 CBD 时复发非常罕见，并且还可能避免额外的 ERCP 程序。
消化