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Saline irrigation of the bile duct prevents residual stones

14 Apr 2018
Those with a history of gallstone disease have a 23% increased risk for coronary heart disease.

Preventive saline irrigation of the bile duct (PSIB) appears to be effective in reducing residual stones after endoscopic common bile duct stone (CBD) removal, according to a recent study.

Researchers randomized 148 patients who underwent endoscopic retrograde cholangiopancreatography to either receive (n=73) or not receive (n=75) PSIB after stone removal. Presence of residual stones was evaluated within 6 months after the operation.

Residual stones were reported in 14.9 percent (n=22), five of whom received PSIB (6.8 percent) while 17 did not (22.7 percent). The difference in residual stone incidence rate reached statistical significance (p=0.01).

Multivariate logistic regression analysis revealed that PSIB had a significant protective effect against residual stones following CBD removal (odds ratio [OR], 0.09; 95 percent CI, 0.02–0.45; p=0.003). In contrast, the presence of multiple CBD stones significantly increased the risk of residual stones (OR, 9.40; 1.86–47.54; p=0.007).

A subsequent subgroup analysis showed that PSIB had greater efficacy against residual stones in patients with multiple CBD stones (rate of residual stones, 12.1 percent in PSIB group vs 50.0 percent in non-PSIB group).

The rate of procedure-related complications was 12.8 percent (n=19), the most common of which was pancreatitis. There was no significant difference in the number of patients who experienced complications in the PSIB vs non-PSIB groups (p=0.793). The rate of cholangitis was slightly higher in the PSIB group (5.5 percent vs 2.7 percent), and all patients were given conservative management.

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Most Read Articles
17 Nov 2017
Total intravenous anaesthesia with propofol yields better survival compared with volatile anaesthetics (VA) for oesophageal cancer surgery, a recent retrospective observational study has found.
06 Sep 2018
Suicide appears to be more common in patients with cancers of the digestive system, especially in those with pancreatic and oesophageal cancers, a recent study has found.
08 Sep 2018
Use of statins may reduce the severity of acute pancreatitis (AP) seen in the decrease of overall incidence of multisystem organ failure (MSOF) and new MSOF, suggests a recent study.
6 days ago
Hospitalization for acute biliary pancreatitis in elderly patients is likely to lead to adverse clinical outcomes, according to a study.