Published online Sep 27, 2026. doi: 10.4240/wjgs.116919
Revised: January 30, 2026
Accepted: August 25, 2026
Published online: September 27, 2026
Processing time: 279 Days and 23.3 Hours
Phytobezoars are gastric concretions formed by plant fibers that can cause various gastrointestinal symptoms. Currently, endoscopic mechanical lithotripsy is the primary treatment modality for these masses. However, conventional methods often face challenges, such as low procedural efficiency, incomplete stone clearan
To evaluate the stone clearance efficiency and clinical safety of M-DCE-ZGL for treating phytobezoars through a retrospective cohort comparison, thereby provi
This retrospective study included 110 patients who underwent gastroscopy between October 2021 and October 2024. Participants were divided into a conventional endoscopy group (polypectomy snare or retrieval basket lithotripsy, n = 67) and a combined endoscopy group (M-DCE-ZGL, n = 43). The indicators assessed included operative duration; time to clinical remission; length of hospital stay; postoperative Visual Analog Scale (VAS) scores at 3 hours, 6 hours, 24 hours, and 72 hours; treatment effectiveness rate at three months; residual stones identified via follow-up endoscopy within two weeks; and complications (gastric perforation, bleeding, mucosal injury, and small bowel obstruction) over three months.
Of the 110 patients (67 conventional and 43 combined), those in the combined group demonstrated significantly shorter lithotripsy durations (45.61 ± 5.94 minutes vs 75.57 ± 6.66 minutes, P < 0.001), fewer lithotripsy sessions (1.22 ± 0.43 vs 1.60 ± 0.87, P = 0.003), and reduced hospital stays (5.89 ± 1.61 days vs 7.14 ± 3.47 days, P = 0.012) than those in the conventional group. The combined group had significantly lower postoperative VAS scores at all time points (all P < 0.05) than the conventional group. The combined group also showed a higher overall efficacy rate (100% vs 80.60%, P = 0.002); lower stone residual rate (4.65% vs 25.37%, P = 0.005); and fewer overall complications (4.65% vs 28.36%, P = 0.002), particularly mucosal injury (4.65% vs 17.91%, P = 0.042), than the conventional group.
Compared with conventional endoscopic lithotripsy methods, M-DCE-ZGL is more efficient and safer for treating phytobezoars.
Core Tip: This retrospective study compared M-type dual-channel endoscopy combined with zebra guidewire lithotripsy vs conventional endoscopic methods for phytobezoar treatment. The combined technique significantly reduced procedure time (45.6 minutes vs 75.6 minutes) and hospital stay (5.9 days vs 7.1 days), achieved a 100% complete clearance rate, and lowered the overall complication rate to 4.65%. It demonstrates superior efficiency and safety, offering an optimized approach for endoscopic management of gastric phytobezoars.