Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Apr 27, 2025; 17(4): 101295
Published online Apr 27, 2025. doi: 10.4240/wjgs.v17.i4.101295
Efficacy of modified pancreatic duct stent drainage during endoscopic retrograde cholangiopancreatography for common bile duct stones
Li-Jia Qian, Chen Xu, Jian-Rong Wang, Jun Quan
Li-Jia Qian, Chen Xu, Jian-Rong Wang, Jun Quan, Department of Digestive Internal, Taizhou Fourth People's Hospital, Taizhou 225300, Jiangsu Province, China
Co-first authors: Li-Jia Qian and Chen Xu.
Author contributions: Qian LJ, Xu C, Wang JR and Quan J contributed to the analysis and interpretation of data; Qian LJ and Xu C contributed to the writing, review, and/or revision of the manuscript. All authors contributed to the acquisition of data (acquired and managed patients) and final approved the manuscript. Qian LJ and Xu C contributed to the conception and design.
Institutional review board statement: The study protocol was approved by the Ethics Committee of Taizhou Fourth People 's Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors who have taken part in this study have nothing to disclose.
Data sharing statement: sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun Quan, Assistant Professor, Department of Digestive Internal, Taizhou Fourth People's Hospital, No. 99 Gulou North Road, Hailing District, Taizhou 225300, Jiangsu Province, China. qjchn@outlook.com
Received: December 20, 2024
Revised: January 18, 2025
Accepted: February 11, 2025
Published online: April 27, 2025
Processing time: 98 Days and 23.3 Hours
Abstract
BACKGROUND

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.

AIM

To investigate the clinical efficacy of modified pancreatic duct stent drainage in endoscopic retrograde cholangiopancreatography (ERCP) for treating common bile duct stones.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

Keywords: Modified pancreatic duct stent drainage; Endoscopic retrograde cholangiopancreatography; Common bile duct stones; Curative effect; Complications

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.