Using cholecystokinin to facilitate endoscopic clearance of large common bile duct stones

Table 1 Baseline characteristics of the patients in the two groups n (%)

	CCK group(n = 74)	No CCK group(n = 74)	P value
Age (yr, mean ± SD)	67.5 ± 5.6	69.2 ± 6.3	0.542
Sex (male/female)	40/34	38/36	0.338
Bile duct stricture	32 (43.2)	30 (40.5)	0.292
Pre-cut sphincterotomy	39 (52.7)	40 (54.1)	0.451
Altered anatomy	21 (28.4)	19 (25.7)	0.319
Multiple stones	29 (39.2)	26 (35.1)	0.267
Stone size (mm), mean ± SD)	18.6 ± 2.4	17.2 ± 3.4	0.326
≥ 30 mm stone	11 (14.9)	12 (16.2)	0.195

Analysis of characteristics of patients enrolled in the study. Patient baseline characteristics include age, sex, bile duct stricture, pre-cut sphincterotomy, altered anatomy, multiple stones, stone size, and the presence of extremely large stones (≥ 30 mm). There were no significant differences between patients in the cholecystokinin (CCK) and no CCK groups in terms of these characteristics.

Table 2 Endoscopic stone removal after extracorporeal shock wave lithotripsy/endoscopic retrograde cholangiopancreatography procedure n (%)

Attempt	CCK group (n = 74)	No CCK group (n = 74)	P value
First	53/74 (71.6)	41/74 (55.4)	0.0351
Second	9/21 (42.8)	13/33 (39.4)	0.218
Third	5/12 (41.7)	8/20 (40.0)	0.346
Total	67/74 (90.5)	62/74 (83.8)	0.178

¹Analysis of endoscopic stone removal after ESWL/ERCP procedure in the two groups. Successful stone clearance rate after the first session of ESWL/ERCP procedure showed a significant difference between the CCK group and no CCK group (P < 0.05). common bile duct clearance rate after the second and third sessions of ESWL/ERCP procedure and total clearance rate did not show a significant difference. CCK: Cholecystokinin; ESWL: Extracorporeal shock wave lithotripsy; ERCP: Endoscopic retrograde cholangiopancreatography.

Table 3 Extraction methods and success rate after extracorporeal shock wave lithotripsy/endoscopic retrograde cholangiopancreatography procedure n (%)

Extraction method	Success rate
	CCK group(n = 74)	No CCK group(n = 74)	P value
Balloon or Dormia basket	64/69	55/61	0.315
Mechanical lithotripsy	3/5	7/13	0.0231
Stone size
15-30 mm	59/60	57/62	0.415
≥ 30 mm	8/11	5/12	0.0382
Total	67 (90.5)	62 (83.8)	0.178

¹Analysis of extraction methods and success rate after ESWL/ERCP procedure in the two groups. Patients needing balloon or Dormia basket to clear CBD stones did not show a significant difference between the CCK group and the no CCK group, while mechanical lithotripsy usage was significantly different (P < 0.05);

²Successful clearance rate of patients with stones 15-30 mm was similar between the two groups, but clearance rate of patients with stones ≥ 30 mm between the two groups show significant difference (P < 0.05). CCK: Cholecystokinin; ESWL: Extracorporeal shock wave lithotripsy; ERCP: Endoscopic retrograde cholangiopancreatography.

Table 4 Complications in cholecystokinin group and no cholecystokinin group n (%)

	CCK group	No CCK group	P value
Complications, post-ERCP	9/103 (8.7)	10/125 (8.0)	0.528
Pancreatitis (mild)	4	5
Cholangitis (mild)	4	3
Hemobilia (mild)	1	2
Bowel perforation	0	0
Procedure-related mortality	0	0
Complications, post-ESWL	8/107 (7.5)	10/127 (7.9)	0.673
Purpuric spots	5	6
Skin ecchymosis	3	4
Splenic rupture	0	0
Lung trauma	0	0
Necrotizing pancreatitis	0	0
Procedure-related mortality	0	0

Analysis of complications in CCK group and no CCK group. These include post-ERCP and post-ESWL complications. The overall post-ERCP and post-ESWL complications are not significantly different between the two groups. CK: Cholecystokinin; ESWL: Extracorporeal shock wave lithotripsy; ERCP: Endoscopic retrograde cholangiopancreatography.