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Effect of ursodeoxycholic acid and endoscopic sphincterotomy in long‐term stenting for common bile duct stones
Author(s) -
Nishizawa Toshihiro,
Suzuki Hidekazu,
Takahashi Masahiko,
Kaneko Hiroshi,
Suzuki Masayuki,
Hibi Toshifumi
Publication year - 2013
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12012
Subject(s) - medicine , ursodeoxycholic acid , stent , hazard ratio , biliary stent , surgery , bile duct , common bile duct , combination therapy , gastroenterology , confidence interval
Abstract Background and Aim We investigated the patency rate of a biliary stent and the effects of ursodeoxycholic acid ( UDCA ) therapy and endoscopic sphincterotomy ( EST ) for difficult‐to‐remove common bile duct stones. Method A total of 63 endoscopic retrograde cholangiopancreatographies ( ERCPs ) were performed in 36 patients (mean age, 86.0 years; male–female, 17:19) for stenting. Among the 63 subjects, 28 were further treated with EST ; 20, with UDCA therapy; and 43, without UDCA therapy. Results The mean patency time was significantly longer in the UDCA treatment group (1,012 days) than in the “stent without UDCA” group (354 days; P = 0.0002; hazard ratio, 0.253). The mean patency time was significantly longer in the patients who had stent placement with EST (1074 days) than in those who had stent placement without EST (279 days; P = 0.001; hazard ratio, 0.439). The mean patency time was significantly longer in the patients who had stent placement with UDCA therapy and EST (1211 days) than in the patients who had stent placement with either UDCA therapy or EST (425 days; P = 0.031; hazard ratio, 0.3292). The mean patency time was significantly longer in the patients who had stent placement with either UDCA therapy or EST than in those who had stent placement without UDCA therapy or EST (263 days; P = 0.0465; hazard ratio, 0.5124). Conclusion Biliary stenting combined with UDCA therapy and EST may be considered as an effective treatment method for cases of common bile duct stones in elderly patients that are difficult to remove.