Initial experience with ultrafine choledochoscopy combined with low-dose atropine for the treatment of Oddi intersphincter stones

doi:10.4240/wjgs.v17.i3.102998

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Surg. Mar 27, 2025; 17(3): 102998
Published online Mar 27, 2025. doi: 10.4240/wjgs.v17.i3.102998

Initial experience with ultrafine choledochoscopy combined with low-dose atropine for the treatment of Oddi intersphincter stones

Xiao-Si Hu, Yong Wang, Hong-Tao Pan, Chao Zhu, Shuai Zhou, Shi-Lei Chen, Hui-Chun Liu, Qing Pang, Hao Jin

Xiao-Si Hu, Yong Wang, Hong-Tao Pan, Chao Zhu, Shuai Zhou, Shi-Lei Chen, Hui-Chun Liu, Qing Pang, Hao Jin, Department of Hepatopancreatobiliary Surgery, Anhui No. 2 Provincial People’s Hospital, Hefei 230041, Anhui Province, China

Co-corresponding authors: Qing Pang and Hao Jin.

Author contributions: Hu XS and Wang Y prepared this manuscript; Pan HT and Zhou S performed the statistical analysis and the literature research; Hu XS, Zhu C and Chen SL contributed to data collection and analysis; Jin H and Pang Q played indispensable roles in the study design, data analysis and manuscript preparation as the co-corresponding authors; Jin H conceptualized, designed, and supervised the whole process of the study; Pang Q was responsible for data re-analysis, figures and tables plotting, language polishing, and literature search. This collaboration between Jin H and Pang Q is crucial for the publication of this manuscript.

Supported by Health Research Program of Anhui, No. AHWJ2023A30034.

Institutional review board statement: This study received approval from the Ethics Committee of Anhui No. 2 Provincial People’s Hospital (approval number: 2023016).

Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to operation.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: Participants gave informed consent for data sharing.

Corresponding author: Hao Jin, Department of Hepatopancreatobiliary Surgery, Anhui No. 2 Provincial People’s Hospital, No. 1868 Dangshan Road, Hefei 230041, Anhui Province, China. jinhaogandan@126.com

Received: November 5, 2024
Revised: December 21, 2024
Accepted: January 20, 2025
Published online: March 27, 2025
Processing time: 112 Days and 2.5 Hours

Abstract

BACKGROUND

In recent years, the use of ultrafine choledochoscopy has gradually increased in the treatment of cholelithiasis. However, stone incarceration and residual spasm of the sphincter of Oddi may be inevitable when an ultrafine choledochoscope is used alone.

AIM

To investigate the safety and feasibility of ultrafine choledochoscopy combined with low-dose atropine in the treatment of Oddi intersphincter stones.

METHODS

Seventeen patients with Oddi intersphincter stones were retrospectively analyzed. The perioperative clinical data and follow-up information were collected.

RESULTS

Among the 17 patients, 3 were male and 14 were female. The mean age was 40.6 ± 13.9 years, and the mean diameter of the common bile duct was 7.8 ± 1.3 mm. All patients successfully underwent Oddi intersphincter stone removal using a combination of ultrafine choledochoscopy and low-dose atropine. No serious complications, such as postoperative hemorrhage, pancreatitis or bile leakage occurred in the 17 patients. During the one-year follow-up, none of the patients experienced stone recurrence.

CONCLUSION

Ultrafine choledochoscopy combined with low-dose atropine is safe and feasible for the treatment of Oddi intersphincter stones.

Keywords: Ultrafine choledochoscope; Atropine; Oddi intersphincter stone; Choledocholithiasis

Core Tip: The application of ultrafine choledochoscopy has gradually been used in the treatment of cholelithiasis. However, stone incarceration with residual stones and spasm of the sphincter of Oddi may still occur. We investigated the safety and feasibility of an ultrafine choledochoscope combined with low-dose atropine for the treatment of Oddi intersphincter stones. All 17 patients successfully underwent Oddi intersphincter stone removal using a combination of ultrafine choledochoscopy and low-dose atropine. No serious complications, such as postoperative hemorrhage, pancreatitis or bile leakage occurred. None of the patients experienced stone recurrence during follow-up. Therefore, ultrafine choledochoscopy combined with low-dose atropine is safe and feasible for the treatment of Oddi intersphincter stones.