Residual common bile duct stones on direct peroral cholangioscopy using ultraslim endoscope

Table 1 Patient characteristics n (%)

Characteristics	n = 22
Age (yr)	73.4 ± 11.8 (range, 40-89)
Gender (male)	15 (68)
Prior cholecystectomies1	19 (86.4)
Acalculous gallbladder	3 (13.6)
Juxtapapillary diverticulum	8 (36.4)
Subtotal gastrectomy with Billroth-II anastomosis	2 (9.1)
Total gastrectomy with Roux-en-Y anastomosis	1 (4.5)
Patients with recurrent CBD stones	12 (54.5)

¹Including 17 cases of open cholecystectomy and 2 cases of laparoscopic cholecystectomy. CBD: Common bile duct.

Table 2 Results of endoscopic retrograde cholangiography n (%)

Characteristics	n = 22
CBD stones
No. of stones (one/two/three/more than three)	10/2/4/6
Mean maximum diameter (mm)	13.4 ± 5.6 (range, 5-25.4)
Mean maximum diameter of CBD (mm)	17.9 (range, 10-30)
ES and/or EPBD
ES	1 (4.5)
EPBD	13 (59.1)
ES + EPBD	6 (27.3)
None1	2 (9.1)
Mean maximum inflated diameter during EPBD2 (mm)	13.6 (range, 12-15)
Stone extraction methods
Balloon and/or basket	20 (90.9)
Mechanical lithotripter	2 (9.1)
Intact stone extraction	11 (50)

¹Endoscopic papillary balloon dilatation (EPBD) was performed during the previous endoscopic session, and the papillary orifice was adequate;

²A total of 15 cases underwent EPBD. CBD: Common bile duct; ES: Endoscopic sphincterotomy.

Table 3 Results of peroral cholangioscopy n (%)

Characteristics	n = 22
Mean procedure time (min)	8.2 (range, 5-18)
The endoscope reached
Hilum or IHD	8 (36.4)
CBD and the hilum was seen	10 (45.5)
Distal CBD and the hilum was not seen	4 (18.2)
Residual stones on the POC
No. of patients	5 (22.7)
No. of residual stones (one/three/multiple)	3/1/1
Maximum diameter of stones (range, mm)	2-5

IHD: Intrahepatic duct; CBD: Common bile duct; POC: Peroral cholangioscopy

Table 4 Clinical features between the patients with and without residual bile duct stones n (%)

	With residual stones (n = 5)	Without residual stones (n = 17)
Age (yr)	69 ± 18.6	74.7 ± 9.5
Sex (male)	4 (80)	11 (64.7)
Recurrent CBD stones	4 (80)	7 (41.2)
Prior choledocholithotomy	3 (60)	6 (35.3)
Mean maximum CBD diameter (mm)	19 ± 7.6	17.6 ± 4.5
Stones number (single)	2 (40)	8 (47)
Mean maximum stone diameter (mm)	14.1 ± 7.2	13.2 ± 5.2
Lithotripsy	0 (0)	2 (11.8)
Intact stone extraction	1 (20)	10 (58.9)
Diameter of EPBD1 (mm)	13.5 ± 1.7 (n = 4)	13.5 ± 1.4

¹Mean maximum inflated diameter of the balloon during endoscopic papillary balloon dilatation (EPBD). CBD: Common bile duct.