The Experts below are selected from a list of 126 Experts worldwide ranked by ideXlab platform

Hiromitsu Saisho - One of the best experts on this subject based on the ideXlab platform.

  • clinical utility of intraductal us to decrease early recurrence rate of common bile duct stones after Endoscopic Papillotomy
    Journal of Gastroenterology and Hepatology, 2008
    Co-Authors: Shin Tsuchiya, Toshio Tsuyuguchi, Hiromitsu Saisho, Yuji Sakai, Harutoshi Sugiyama, Takeshi Ando, Kaoru Miyagawa, Yoshihiro Fukuda, Osamu Yokosuka
    Abstract:

    Background and Aim:  The aim of the present study was to determine whether additional intraductal ultrasound (IDUS) to confirm complete stone clearance decreases the recurrence rate of common bile duct stones for a 3-year period after Endoscopic Papillotomy (EPT). Methods:  IDUS was carried out with a thin-caliber ultrasonic probe (diameter 2.0 mm, frequency 20 MHz) via transpapillary route after stone extraction. If IDUS showed evidence of residual stones and/or sludge, Endoscopic management was performed until IDUS examination was negative. A prospective study was conducted on 59 consecutive patients undergoing additional IDUS after stone extraction between January 1996 and May 2003 (IDUS group). The recurrence rate of common bile duct stones was compared with a historical control group (August 1988 to December 1995) consisting of cases that did not undergo IDUS (non-IDUS group). Potential risk factors for recurrence of common bile duct stones were assessed by univariate and multivariate analysis on logistic regression. Results:  In 14 of 59 patients (23.7%), IDUS detected small residual stones not seen on cholangiography. The recurrence rate was 13.2% (17 of 129 patients) in the non-IDUS group and 3.4% (two of 59 patients) in the IDUS group (P < 0.05). Multivariate analysis subsequently identified non-IDUS status as an independent risk factor for recurrence (odds ratio 5.12, 95% CI 1.11–23.52, P = 0.036). Conclusions:  Additional IDUS to confirm complete stone clearance after EPT decreases the early recurrence rate of common bile duct stones.

  • Clinical utility of intraductal US to decrease early recurrence rate of common bile duct stones after Endoscopic Papillotomy
    Journal of gastroenterology and hepatology, 2008
    Co-Authors: Shin Tsuchiya, Toshio Tsuyuguchi, Hiromitsu Saisho, Yuji Sakai, Harutoshi Sugiyama, Takeshi Ando, Kaoru Miyagawa, Yoshihiro Fukuda, Osamu Yokosuka
    Abstract:

    Background and Aim:  The aim of the present study was to determine whether additional intraductal ultrasound (IDUS) to confirm complete stone clearance decreases the recurrence rate of common bile duct stones for a 3-year period after Endoscopic Papillotomy (EPT). Methods:  IDUS was carried out with a thin-caliber ultrasonic probe (diameter 2.0 mm, frequency 20 MHz) via transpapillary route after stone extraction. If IDUS showed evidence of residual stones and/or sludge, Endoscopic management was performed until IDUS examination was negative. A prospective study was conducted on 59 consecutive patients undergoing additional IDUS after stone extraction between January 1996 and May 2003 (IDUS group). The recurrence rate of common bile duct stones was compared with a historical control group (August 1988 to December 1995) consisting of cases that did not undergo IDUS (non-IDUS group). Potential risk factors for recurrence of common bile duct stones were assessed by univariate and multivariate analysis on logistic regression. Results:  In 14 of 59 patients (23.7%), IDUS detected small residual stones not seen on cholangiography. The recurrence rate was 13.2% (17 of 129 patients) in the non-IDUS group and 3.4% (two of 59 patients) in the IDUS group (P 

  • Risk factors for recurrent bile duct stones after Endoscopic Papillotomy
    Gut, 2003
    Co-Authors: Takeshi Ando, M. Saito, Toshio Tsuyuguchi, Taketo Yamaguchi, Takeshi Ishihara, T Okugawa, Hiromitsu Saisho
    Abstract:

    Background: The long term outcome of Endoscopic Papillotomy (EPT) is not well known. The aims of this study were to clarify the clinical course of post-EPT patients and to detect predictors for bile duct stone recurrence. Methods: A total of 1042 consecutive patients who underwent EPT for bile duct stones from December 1975 to September 1998 were prospectively followed up. Patients were divided into four groups according to gall bladder (GB) status: “acalculous GB” group, “calculous GB” group, “cholecystectomy” group, and “prior cholecystectomy” group. Reliable follow up information was obtained for 983 (94.3%) of the 1042 patients. The following factors were considered in the evaluation of predisposing risk factors for recurrence of bile duct stones: age, sex, gall bladder status, periampullary diverticulum, number of bile duct stones, diameter of bile duct stones, diameter of bile duct, lithotripsy, precutting, pneumobilia, and early complications. Results: Recurrence occurred in 111 patients. The “acalculous GB” group was less prone to recurrence than the “prior cholecystectomy” group and the “calculous GB” group. The relative risks (RR) for the latter two compared with the former group were 2.26 (95% confidence interval (CI) 1.24–4.14; p=0.0078) and 2.16 (95% CI 1.21–3.87; p=0.0093), respectively. Other prognostic factors were lithotripsy (RR 2.37; 95% CI 1.47–3.81; p=0.0004) and pneumobilia (RR 1.57; 95% CI 1.01–2.43; p=0.044). Conclusions: Gall bladder status, lithotripsy, and pneumobilia were significantly related to bile duct stone recurrence after EPT.

  • Long-term outcome of Endoscopic Papillotomy for choledocholithiasis with cholecystolithiasis.
    Gastrointestinal endoscopy, 2000
    Co-Authors: M. Saito, Toshio Tsuyuguchi, Taketo Yamaguchi, Takeshi Ishihara, Hiromitsu Saisho
    Abstract:

    Abstract Background: Although Endoscopic Papillotomy is now considered established treatment for choledocholithiasis, therapeutic results of Endoscopic Papillotomy alone without subsequent cholecystectomy in patients with cholecystolithiasis have not been well evaluated. The aim of this study was to assess the long-term outcome of Endoscopic Papillotomy for these patients. Methods: Patients admitted with choledocholithiasis and cholecystolithiasis from 1976 to 1993 were studied retrospectively. Of 385 patients in whom the bile duct was cleared by Endoscopic Papillotomy and Endoscopic stone extraction, 371 patients (195 men and 176 women; mean age 65.4 years) were followed. Predisposing risk factors for late complications were analyzed. Results: The mean duration of follow-up was 7.7 years. Cholecystitis and recurrence of choledocholithiasis as late complications occurred in 22 cases (5.9%) and 36 cases (9.7%), respectively. Cholecystitis, including 1 severe case, resolved with conservative treatment. Recurrent choledocholithiasis was successfully treated Endoscopically except in 1 case. No significant risk factors were identified for cholecystitis. The presence of pneumobilia ( p = 0.0016) and the need for lithotripsy ( p = 0.0342) were found to be significant risk factors for the recurrence of choledocholithiasis. Conclusions: Long-term outcome of Endoscopic Papillotomy in patients with choledocholithiasis and cholecystolithiasis was found to be relatively favorable. Cholecystectomy after Endoscopic Papillotomy is not always necessary in the management of cholecystolithiasis. (Gastrointest Endosc 2000;51:540-5.)

Toshio Tsuyuguchi - One of the best experts on this subject based on the ideXlab platform.

  • Long-term outcome of Endoscopic Papillotomy for choledocholithiasis with cholecystolithiasis.
    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society, 2010
    Co-Authors: Tatsuya Fujimoto, Toshio Tsuyuguchi, Takeshi Ishihara, Yuji Sakai, Harutoshi Sugiyama, Kaoru Miyakawa, Reiko Eto, Shin Yasui, Osamu Yokosuka
    Abstract:

    Aim:  To assess long-term outcome of Endoscopic Papillotomy alone without subsequent cholecystectomy in patients with choledocholithiasis and cholecystolithiasis. Methods:  Retrospective review of clinical records of patients treated for choledocholithiasis and cholecystolithiasis from 1976 to 2006. Of 564 patients subjected to Endoscopic Papillotomy and Endoscopic stone extraction, 522 patients (279 men, 243 women; mean age 66.2 years) were followed up and predisposing risk factors for late complications were analyzed. Results:  The mean duration of follow up was 5.6 years. Cholecystitis and recurrent choledocholithiasis occurred in 39 (7.5%) and 60 (11.5%) patients, respectively. Cholecystitis, including one severe case, resolved with conservative treatment. Recurrent choledocholithiasis was successfully treated Endoscopically except in one case. Pneumobilia was found to be a significant risk factor for cholecystitis (P = 0.019) and recurrent choledocholithiasis (P = 0.013). Biliary tract cancer occurred in 16 patients; gallbladder cancer in 13 and bile duct cancer in three. Gallbladder cancer developed within 2 years after Endoscopic Papillotomy in seven of the 13 patients (53.8%). Conclusion:  Pneumobilia was the only significant risk factor for cholecystitis and recurrent choledocholithiasis in our study population. As for the long-term outcome, it was unclear whether Endoscopic Papillotomy contributed to the occurrence of biliary tract cancer.

  • clinical utility of intraductal us to decrease early recurrence rate of common bile duct stones after Endoscopic Papillotomy
    Journal of Gastroenterology and Hepatology, 2008
    Co-Authors: Shin Tsuchiya, Toshio Tsuyuguchi, Hiromitsu Saisho, Yuji Sakai, Harutoshi Sugiyama, Takeshi Ando, Kaoru Miyagawa, Yoshihiro Fukuda, Osamu Yokosuka
    Abstract:

    Background and Aim:  The aim of the present study was to determine whether additional intraductal ultrasound (IDUS) to confirm complete stone clearance decreases the recurrence rate of common bile duct stones for a 3-year period after Endoscopic Papillotomy (EPT). Methods:  IDUS was carried out with a thin-caliber ultrasonic probe (diameter 2.0 mm, frequency 20 MHz) via transpapillary route after stone extraction. If IDUS showed evidence of residual stones and/or sludge, Endoscopic management was performed until IDUS examination was negative. A prospective study was conducted on 59 consecutive patients undergoing additional IDUS after stone extraction between January 1996 and May 2003 (IDUS group). The recurrence rate of common bile duct stones was compared with a historical control group (August 1988 to December 1995) consisting of cases that did not undergo IDUS (non-IDUS group). Potential risk factors for recurrence of common bile duct stones were assessed by univariate and multivariate analysis on logistic regression. Results:  In 14 of 59 patients (23.7%), IDUS detected small residual stones not seen on cholangiography. The recurrence rate was 13.2% (17 of 129 patients) in the non-IDUS group and 3.4% (two of 59 patients) in the IDUS group (P < 0.05). Multivariate analysis subsequently identified non-IDUS status as an independent risk factor for recurrence (odds ratio 5.12, 95% CI 1.11–23.52, P = 0.036). Conclusions:  Additional IDUS to confirm complete stone clearance after EPT decreases the early recurrence rate of common bile duct stones.

  • Clinical utility of intraductal US to decrease early recurrence rate of common bile duct stones after Endoscopic Papillotomy
    Journal of gastroenterology and hepatology, 2008
    Co-Authors: Shin Tsuchiya, Toshio Tsuyuguchi, Hiromitsu Saisho, Yuji Sakai, Harutoshi Sugiyama, Takeshi Ando, Kaoru Miyagawa, Yoshihiro Fukuda, Osamu Yokosuka
    Abstract:

    Background and Aim:  The aim of the present study was to determine whether additional intraductal ultrasound (IDUS) to confirm complete stone clearance decreases the recurrence rate of common bile duct stones for a 3-year period after Endoscopic Papillotomy (EPT). Methods:  IDUS was carried out with a thin-caliber ultrasonic probe (diameter 2.0 mm, frequency 20 MHz) via transpapillary route after stone extraction. If IDUS showed evidence of residual stones and/or sludge, Endoscopic management was performed until IDUS examination was negative. A prospective study was conducted on 59 consecutive patients undergoing additional IDUS after stone extraction between January 1996 and May 2003 (IDUS group). The recurrence rate of common bile duct stones was compared with a historical control group (August 1988 to December 1995) consisting of cases that did not undergo IDUS (non-IDUS group). Potential risk factors for recurrence of common bile duct stones were assessed by univariate and multivariate analysis on logistic regression. Results:  In 14 of 59 patients (23.7%), IDUS detected small residual stones not seen on cholangiography. The recurrence rate was 13.2% (17 of 129 patients) in the non-IDUS group and 3.4% (two of 59 patients) in the IDUS group (P 

  • Risk factors for recurrent bile duct stones after Endoscopic Papillotomy
    Gut, 2003
    Co-Authors: Takeshi Ando, M. Saito, Toshio Tsuyuguchi, Taketo Yamaguchi, Takeshi Ishihara, T Okugawa, Hiromitsu Saisho
    Abstract:

    Background: The long term outcome of Endoscopic Papillotomy (EPT) is not well known. The aims of this study were to clarify the clinical course of post-EPT patients and to detect predictors for bile duct stone recurrence. Methods: A total of 1042 consecutive patients who underwent EPT for bile duct stones from December 1975 to September 1998 were prospectively followed up. Patients were divided into four groups according to gall bladder (GB) status: “acalculous GB” group, “calculous GB” group, “cholecystectomy” group, and “prior cholecystectomy” group. Reliable follow up information was obtained for 983 (94.3%) of the 1042 patients. The following factors were considered in the evaluation of predisposing risk factors for recurrence of bile duct stones: age, sex, gall bladder status, periampullary diverticulum, number of bile duct stones, diameter of bile duct stones, diameter of bile duct, lithotripsy, precutting, pneumobilia, and early complications. Results: Recurrence occurred in 111 patients. The “acalculous GB” group was less prone to recurrence than the “prior cholecystectomy” group and the “calculous GB” group. The relative risks (RR) for the latter two compared with the former group were 2.26 (95% confidence interval (CI) 1.24–4.14; p=0.0078) and 2.16 (95% CI 1.21–3.87; p=0.0093), respectively. Other prognostic factors were lithotripsy (RR 2.37; 95% CI 1.47–3.81; p=0.0004) and pneumobilia (RR 1.57; 95% CI 1.01–2.43; p=0.044). Conclusions: Gall bladder status, lithotripsy, and pneumobilia were significantly related to bile duct stone recurrence after EPT.

  • Long-term outcome of Endoscopic Papillotomy for choledocholithiasis with cholecystolithiasis.
    Gastrointestinal endoscopy, 2000
    Co-Authors: M. Saito, Toshio Tsuyuguchi, Taketo Yamaguchi, Takeshi Ishihara, Hiromitsu Saisho
    Abstract:

    Abstract Background: Although Endoscopic Papillotomy is now considered established treatment for choledocholithiasis, therapeutic results of Endoscopic Papillotomy alone without subsequent cholecystectomy in patients with cholecystolithiasis have not been well evaluated. The aim of this study was to assess the long-term outcome of Endoscopic Papillotomy for these patients. Methods: Patients admitted with choledocholithiasis and cholecystolithiasis from 1976 to 1993 were studied retrospectively. Of 385 patients in whom the bile duct was cleared by Endoscopic Papillotomy and Endoscopic stone extraction, 371 patients (195 men and 176 women; mean age 65.4 years) were followed. Predisposing risk factors for late complications were analyzed. Results: The mean duration of follow-up was 7.7 years. Cholecystitis and recurrence of choledocholithiasis as late complications occurred in 22 cases (5.9%) and 36 cases (9.7%), respectively. Cholecystitis, including 1 severe case, resolved with conservative treatment. Recurrent choledocholithiasis was successfully treated Endoscopically except in 1 case. No significant risk factors were identified for cholecystitis. The presence of pneumobilia ( p = 0.0016) and the need for lithotripsy ( p = 0.0342) were found to be significant risk factors for the recurrence of choledocholithiasis. Conclusions: Long-term outcome of Endoscopic Papillotomy in patients with choledocholithiasis and cholecystolithiasis was found to be relatively favorable. Cholecystectomy after Endoscopic Papillotomy is not always necessary in the management of cholecystolithiasis. (Gastrointest Endosc 2000;51:540-5.)

Osamu Yokosuka - One of the best experts on this subject based on the ideXlab platform.

  • Long-term outcome of Endoscopic Papillotomy for choledocholithiasis with cholecystolithiasis.
    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society, 2010
    Co-Authors: Tatsuya Fujimoto, Toshio Tsuyuguchi, Takeshi Ishihara, Yuji Sakai, Harutoshi Sugiyama, Kaoru Miyakawa, Reiko Eto, Shin Yasui, Osamu Yokosuka
    Abstract:

    Aim:  To assess long-term outcome of Endoscopic Papillotomy alone without subsequent cholecystectomy in patients with choledocholithiasis and cholecystolithiasis. Methods:  Retrospective review of clinical records of patients treated for choledocholithiasis and cholecystolithiasis from 1976 to 2006. Of 564 patients subjected to Endoscopic Papillotomy and Endoscopic stone extraction, 522 patients (279 men, 243 women; mean age 66.2 years) were followed up and predisposing risk factors for late complications were analyzed. Results:  The mean duration of follow up was 5.6 years. Cholecystitis and recurrent choledocholithiasis occurred in 39 (7.5%) and 60 (11.5%) patients, respectively. Cholecystitis, including one severe case, resolved with conservative treatment. Recurrent choledocholithiasis was successfully treated Endoscopically except in one case. Pneumobilia was found to be a significant risk factor for cholecystitis (P = 0.019) and recurrent choledocholithiasis (P = 0.013). Biliary tract cancer occurred in 16 patients; gallbladder cancer in 13 and bile duct cancer in three. Gallbladder cancer developed within 2 years after Endoscopic Papillotomy in seven of the 13 patients (53.8%). Conclusion:  Pneumobilia was the only significant risk factor for cholecystitis and recurrent choledocholithiasis in our study population. As for the long-term outcome, it was unclear whether Endoscopic Papillotomy contributed to the occurrence of biliary tract cancer.

  • clinical utility of intraductal us to decrease early recurrence rate of common bile duct stones after Endoscopic Papillotomy
    Journal of Gastroenterology and Hepatology, 2008
    Co-Authors: Shin Tsuchiya, Toshio Tsuyuguchi, Hiromitsu Saisho, Yuji Sakai, Harutoshi Sugiyama, Takeshi Ando, Kaoru Miyagawa, Yoshihiro Fukuda, Osamu Yokosuka
    Abstract:

    Background and Aim:  The aim of the present study was to determine whether additional intraductal ultrasound (IDUS) to confirm complete stone clearance decreases the recurrence rate of common bile duct stones for a 3-year period after Endoscopic Papillotomy (EPT). Methods:  IDUS was carried out with a thin-caliber ultrasonic probe (diameter 2.0 mm, frequency 20 MHz) via transpapillary route after stone extraction. If IDUS showed evidence of residual stones and/or sludge, Endoscopic management was performed until IDUS examination was negative. A prospective study was conducted on 59 consecutive patients undergoing additional IDUS after stone extraction between January 1996 and May 2003 (IDUS group). The recurrence rate of common bile duct stones was compared with a historical control group (August 1988 to December 1995) consisting of cases that did not undergo IDUS (non-IDUS group). Potential risk factors for recurrence of common bile duct stones were assessed by univariate and multivariate analysis on logistic regression. Results:  In 14 of 59 patients (23.7%), IDUS detected small residual stones not seen on cholangiography. The recurrence rate was 13.2% (17 of 129 patients) in the non-IDUS group and 3.4% (two of 59 patients) in the IDUS group (P < 0.05). Multivariate analysis subsequently identified non-IDUS status as an independent risk factor for recurrence (odds ratio 5.12, 95% CI 1.11–23.52, P = 0.036). Conclusions:  Additional IDUS to confirm complete stone clearance after EPT decreases the early recurrence rate of common bile duct stones.

  • Clinical utility of intraductal US to decrease early recurrence rate of common bile duct stones after Endoscopic Papillotomy
    Journal of gastroenterology and hepatology, 2008
    Co-Authors: Shin Tsuchiya, Toshio Tsuyuguchi, Hiromitsu Saisho, Yuji Sakai, Harutoshi Sugiyama, Takeshi Ando, Kaoru Miyagawa, Yoshihiro Fukuda, Osamu Yokosuka
    Abstract:

    Background and Aim:  The aim of the present study was to determine whether additional intraductal ultrasound (IDUS) to confirm complete stone clearance decreases the recurrence rate of common bile duct stones for a 3-year period after Endoscopic Papillotomy (EPT). Methods:  IDUS was carried out with a thin-caliber ultrasonic probe (diameter 2.0 mm, frequency 20 MHz) via transpapillary route after stone extraction. If IDUS showed evidence of residual stones and/or sludge, Endoscopic management was performed until IDUS examination was negative. A prospective study was conducted on 59 consecutive patients undergoing additional IDUS after stone extraction between January 1996 and May 2003 (IDUS group). The recurrence rate of common bile duct stones was compared with a historical control group (August 1988 to December 1995) consisting of cases that did not undergo IDUS (non-IDUS group). Potential risk factors for recurrence of common bile duct stones were assessed by univariate and multivariate analysis on logistic regression. Results:  In 14 of 59 patients (23.7%), IDUS detected small residual stones not seen on cholangiography. The recurrence rate was 13.2% (17 of 129 patients) in the non-IDUS group and 3.4% (two of 59 patients) in the IDUS group (P 

Takeshi Ando - One of the best experts on this subject based on the ideXlab platform.

  • clinical utility of intraductal us to decrease early recurrence rate of common bile duct stones after Endoscopic Papillotomy
    Journal of Gastroenterology and Hepatology, 2008
    Co-Authors: Shin Tsuchiya, Toshio Tsuyuguchi, Hiromitsu Saisho, Yuji Sakai, Harutoshi Sugiyama, Takeshi Ando, Kaoru Miyagawa, Yoshihiro Fukuda, Osamu Yokosuka
    Abstract:

    Background and Aim:  The aim of the present study was to determine whether additional intraductal ultrasound (IDUS) to confirm complete stone clearance decreases the recurrence rate of common bile duct stones for a 3-year period after Endoscopic Papillotomy (EPT). Methods:  IDUS was carried out with a thin-caliber ultrasonic probe (diameter 2.0 mm, frequency 20 MHz) via transpapillary route after stone extraction. If IDUS showed evidence of residual stones and/or sludge, Endoscopic management was performed until IDUS examination was negative. A prospective study was conducted on 59 consecutive patients undergoing additional IDUS after stone extraction between January 1996 and May 2003 (IDUS group). The recurrence rate of common bile duct stones was compared with a historical control group (August 1988 to December 1995) consisting of cases that did not undergo IDUS (non-IDUS group). Potential risk factors for recurrence of common bile duct stones were assessed by univariate and multivariate analysis on logistic regression. Results:  In 14 of 59 patients (23.7%), IDUS detected small residual stones not seen on cholangiography. The recurrence rate was 13.2% (17 of 129 patients) in the non-IDUS group and 3.4% (two of 59 patients) in the IDUS group (P < 0.05). Multivariate analysis subsequently identified non-IDUS status as an independent risk factor for recurrence (odds ratio 5.12, 95% CI 1.11–23.52, P = 0.036). Conclusions:  Additional IDUS to confirm complete stone clearance after EPT decreases the early recurrence rate of common bile duct stones.

  • Clinical utility of intraductal US to decrease early recurrence rate of common bile duct stones after Endoscopic Papillotomy
    Journal of gastroenterology and hepatology, 2008
    Co-Authors: Shin Tsuchiya, Toshio Tsuyuguchi, Hiromitsu Saisho, Yuji Sakai, Harutoshi Sugiyama, Takeshi Ando, Kaoru Miyagawa, Yoshihiro Fukuda, Osamu Yokosuka
    Abstract:

    Background and Aim:  The aim of the present study was to determine whether additional intraductal ultrasound (IDUS) to confirm complete stone clearance decreases the recurrence rate of common bile duct stones for a 3-year period after Endoscopic Papillotomy (EPT). Methods:  IDUS was carried out with a thin-caliber ultrasonic probe (diameter 2.0 mm, frequency 20 MHz) via transpapillary route after stone extraction. If IDUS showed evidence of residual stones and/or sludge, Endoscopic management was performed until IDUS examination was negative. A prospective study was conducted on 59 consecutive patients undergoing additional IDUS after stone extraction between January 1996 and May 2003 (IDUS group). The recurrence rate of common bile duct stones was compared with a historical control group (August 1988 to December 1995) consisting of cases that did not undergo IDUS (non-IDUS group). Potential risk factors for recurrence of common bile duct stones were assessed by univariate and multivariate analysis on logistic regression. Results:  In 14 of 59 patients (23.7%), IDUS detected small residual stones not seen on cholangiography. The recurrence rate was 13.2% (17 of 129 patients) in the non-IDUS group and 3.4% (two of 59 patients) in the IDUS group (P 

  • Risk factors for recurrent bile duct stones after Endoscopic Papillotomy
    Gut, 2003
    Co-Authors: Takeshi Ando, M. Saito, Toshio Tsuyuguchi, Taketo Yamaguchi, Takeshi Ishihara, T Okugawa, Hiromitsu Saisho
    Abstract:

    Background: The long term outcome of Endoscopic Papillotomy (EPT) is not well known. The aims of this study were to clarify the clinical course of post-EPT patients and to detect predictors for bile duct stone recurrence. Methods: A total of 1042 consecutive patients who underwent EPT for bile duct stones from December 1975 to September 1998 were prospectively followed up. Patients were divided into four groups according to gall bladder (GB) status: “acalculous GB” group, “calculous GB” group, “cholecystectomy” group, and “prior cholecystectomy” group. Reliable follow up information was obtained for 983 (94.3%) of the 1042 patients. The following factors were considered in the evaluation of predisposing risk factors for recurrence of bile duct stones: age, sex, gall bladder status, periampullary diverticulum, number of bile duct stones, diameter of bile duct stones, diameter of bile duct, lithotripsy, precutting, pneumobilia, and early complications. Results: Recurrence occurred in 111 patients. The “acalculous GB” group was less prone to recurrence than the “prior cholecystectomy” group and the “calculous GB” group. The relative risks (RR) for the latter two compared with the former group were 2.26 (95% confidence interval (CI) 1.24–4.14; p=0.0078) and 2.16 (95% CI 1.21–3.87; p=0.0093), respectively. Other prognostic factors were lithotripsy (RR 2.37; 95% CI 1.47–3.81; p=0.0004) and pneumobilia (RR 1.57; 95% CI 1.01–2.43; p=0.044). Conclusions: Gall bladder status, lithotripsy, and pneumobilia were significantly related to bile duct stone recurrence after EPT.

M. Saito - One of the best experts on this subject based on the ideXlab platform.

  • Risk factors for recurrent bile duct stones after Endoscopic Papillotomy
    Gut, 2003
    Co-Authors: Takeshi Ando, M. Saito, Toshio Tsuyuguchi, Taketo Yamaguchi, Takeshi Ishihara, T Okugawa, Hiromitsu Saisho
    Abstract:

    Background: The long term outcome of Endoscopic Papillotomy (EPT) is not well known. The aims of this study were to clarify the clinical course of post-EPT patients and to detect predictors for bile duct stone recurrence. Methods: A total of 1042 consecutive patients who underwent EPT for bile duct stones from December 1975 to September 1998 were prospectively followed up. Patients were divided into four groups according to gall bladder (GB) status: “acalculous GB” group, “calculous GB” group, “cholecystectomy” group, and “prior cholecystectomy” group. Reliable follow up information was obtained for 983 (94.3%) of the 1042 patients. The following factors were considered in the evaluation of predisposing risk factors for recurrence of bile duct stones: age, sex, gall bladder status, periampullary diverticulum, number of bile duct stones, diameter of bile duct stones, diameter of bile duct, lithotripsy, precutting, pneumobilia, and early complications. Results: Recurrence occurred in 111 patients. The “acalculous GB” group was less prone to recurrence than the “prior cholecystectomy” group and the “calculous GB” group. The relative risks (RR) for the latter two compared with the former group were 2.26 (95% confidence interval (CI) 1.24–4.14; p=0.0078) and 2.16 (95% CI 1.21–3.87; p=0.0093), respectively. Other prognostic factors were lithotripsy (RR 2.37; 95% CI 1.47–3.81; p=0.0004) and pneumobilia (RR 1.57; 95% CI 1.01–2.43; p=0.044). Conclusions: Gall bladder status, lithotripsy, and pneumobilia were significantly related to bile duct stone recurrence after EPT.

  • Long-term outcome of Endoscopic Papillotomy for choledocholithiasis with cholecystolithiasis.
    Gastrointestinal endoscopy, 2000
    Co-Authors: M. Saito, Toshio Tsuyuguchi, Taketo Yamaguchi, Takeshi Ishihara, Hiromitsu Saisho
    Abstract:

    Abstract Background: Although Endoscopic Papillotomy is now considered established treatment for choledocholithiasis, therapeutic results of Endoscopic Papillotomy alone without subsequent cholecystectomy in patients with cholecystolithiasis have not been well evaluated. The aim of this study was to assess the long-term outcome of Endoscopic Papillotomy for these patients. Methods: Patients admitted with choledocholithiasis and cholecystolithiasis from 1976 to 1993 were studied retrospectively. Of 385 patients in whom the bile duct was cleared by Endoscopic Papillotomy and Endoscopic stone extraction, 371 patients (195 men and 176 women; mean age 65.4 years) were followed. Predisposing risk factors for late complications were analyzed. Results: The mean duration of follow-up was 7.7 years. Cholecystitis and recurrence of choledocholithiasis as late complications occurred in 22 cases (5.9%) and 36 cases (9.7%), respectively. Cholecystitis, including 1 severe case, resolved with conservative treatment. Recurrent choledocholithiasis was successfully treated Endoscopically except in 1 case. No significant risk factors were identified for cholecystitis. The presence of pneumobilia ( p = 0.0016) and the need for lithotripsy ( p = 0.0342) were found to be significant risk factors for the recurrence of choledocholithiasis. Conclusions: Long-term outcome of Endoscopic Papillotomy in patients with choledocholithiasis and cholecystolithiasis was found to be relatively favorable. Cholecystectomy after Endoscopic Papillotomy is not always necessary in the management of cholecystolithiasis. (Gastrointest Endosc 2000;51:540-5.)