Published online Apr 27, 2025. doi: 10.4240/wjgs.v17.i4.101295
Revised: January 18, 2025
Accepted: February 11, 2025
Published online: April 27, 2025
Processing time: 98 Days and 23.3 Hours
Common bile duct stones pose a high risk of recurrence or disease progression if not promptly treated. However, there is still no optimal treatment approach.
To investigate the clinical efficacy of modified pancreatic duct stent drainage in endoscopic retrograde cholangiopancreatography (ERCP) for treating common bile duct stones.
This retrospective study included 175 patients with common bile duct stones treated at Taizhou Fourth People’s Hospital between January 1, 2021, and November 30, 2023. The patients were divided into three groups-the modified pancreatic duct stent drainage group (59 cases), the nasobiliary drainage group (58 cases), and the standard biliary drainage group (58 cases). Preoperative general clinical data, laboratory indicators, and the visual analog scale (VAS) at two time points (24 hours before and after surgery) were compared, along with postoperative complications across the three groups.
Serum levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, gamma-glutamyltransferase, total bilirubin, direct bilirubin, C-reactive protein, and amylase were significantly lower in the modified pancreatic duct stent drainage group and the standard biliary drainage group than those in the nasobiliary drainage group (P < 0.05). However, no statistically significant differences were observed in white blood cells, hemoglobin, or neutrophil levels among the three groups (P > 0.05). The standard biliary drainage group had significantly lower VAS scores [(4.36 ± 1.18) points] than those for the modified pancreatic duct stent drainage group [(4.92 ± 1.68) points] (P = 0.033), and the nasobiliary drainage group [(5.54 ± 1.24) points] (P = 0.017). There were no statistically significant differences in complication rates across the three groups (P > 0.05).
Compared to standard biliary drainage and nasobiliary drainage, the modified pancreatic duct stent used during ERCP for patients with bile duct stones significantly reduced hepatocyte injury, improved liver function parameters, alleviated inflammation and pain, enhanced patient comfort, and demonstrated superior safety.
Core Tip: There is currently a paucity of multidimensional comparative analyses concerning the clinical efficacy of modified pancreatic duct plastic stents for endoscopic retrograde biliary drainage, endoscopic nasobiliary drainage, and Christmas tree-shaped plastic stents for standard biliary drainage following endoscopic retrograde cholangiopancreatography (ERCP) for common bile duct stone removal. This study addresses this gap with a comprehensive analysis. Our findings reveal that compared to standard biliary drainage and nasobiliary drainage, modified pancreatic stents offer significant benefits, including a significant reduction in hepatocyte damage, improvement in liver function parameters, alleviated inflammation and pain, enhanced patient comfort, and increased treatment safety. Therefore, we recommend modified pancreatic plastic stents as the preferred post-ERCP drainage method for patients with common bile duct stones.