National Survey Regarding the Management of Difficult Bile Duct Stones in South Korea
- Authors
- Lee, Yoon Suk; Jeon, Tae Joo; Paik, Woo Hyun; Ahn, Dong-Won; Chung, Kwang Hyun; Son, Byoung Kwan; Song, Tae Jun; Moon, Sung-Hoon; Lee, Eaum Seok; Lee, Jae Min; Yoon, Seung Bae; Paik, Chang Nyol; Lee, Yun Nah; Park, Jin-Seok; Lee, Dong Wook; Park, Sang Wook; Chon, Hyung Ku; Cho, Kwang Bum; Park, Chang Hwan
- Issue Date
- May-2023
- Publisher
- 거트앤리버 발행위원회
- Keywords
- Key Words; Bile ducts; Gallstones; Endoscopy; Cholangiopancreatography endoscopic retro-grade; Surveys and questionnaires
- Citation
- Gut and Liver, v.17, no.3, pp 475 - 481
- Pages
- 7
- Journal Title
- Gut and Liver
- Volume
- 17
- Number
- 3
- Start Page
- 475
- End Page
- 481
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/21665
- DOI
- 10.5009/gnl220117
- ISSN
- 1976-2283
2005-1212
- Abstract
- Background/Aims: This study aimed to investigate the patterns of preferred endoscopic proce-dure types and techniques for managing difficult common bile duct (CBD) stones in South Korea. Methods: The Committee of Policy and Quality Management of Korean Pancreatobiliary Asso-ciation (KPBA) conducted a survey containing 19 questions. Both paper and online surveys were carried out; with the paper survey being conducted during the 2019 Annual Congress of KPBA and the online survey being conducted through Google Forms from April 2020 to February 2021. Results: The response rate was approximately 41.3% (86/208). Sixty-two (73.0%) worked at tertiary hospitals or academic medical centers, and 60 (69.7%) had more than 5 years of en-doscopic retrograde cholangiopancreatography experience. The preferred size criteria for large CBD stones were 15 mm (40.6%), 20 mm (31.3%), and 30 mm (4.6%). For managing of large CBD stones, endoscopic papillary large balloon dilation after endoscopic sphincterotomy was the most preferred technique (74.4%). When performing procedures in those with bleeding diathesis, 64 (74.4%) respondents favored endoscopic papillary balloon dilation (EPBD) alone or EPBD with small endoscopic sphincterotomy. Fifty-five respondents (63.9%) preferred the double-guidewire technique when faced with difficult bile duct cannulation in patients with periampullary diverticulum. In surgically altered anatomies, cap-fitted forward viewing endoscopy (76.7%) and percutaneous transhepatic cholangioscopy (48.8%) were the preferred techniques for Billroth-II anastomosis and total gastrectomy with Roux-en-Y anastomosis, respectively. Conclusions: Most respondents showed unifying trends for the management of difficult CBD stones. The current practice patterns could be used as basic data for clinical quality improve-ments in the management of difficult CBD stones. (Gut Liver, Published online July 19, 2022)
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