Effectiveness of endoscopic treatment in the management of choledocholithiasis in the servicio de endoscopía digestiva, Hospital Nacional de Itauguá during the period 2019-2021

Abstract

Introduction: Choledocholithiasis refers to any stone lodged in the main bile duct. The most common form is secondary choledocholithiasis, due to the passage of the stone from the gallbladder to the common bile duct through the cystic duct. Objective: To determine the effectiveness of endoscopic treatment in the resolution of choledocholithiasis in the Digetive Endoscopy Service of the National Hospital of Itauguá. Materials and methods: Observational, descriptive, retrospective cross-sectional study. Results: A total of 121 patients were evaluated, of which 66.1% were female and 33.9% male. The main indication for ERCP was by very strong criteria of the ASGE in 77% of the cases. In 50, 4% of them ERCP was positive for stone extraction; in 36.4% the exploration was negative and in 13.2% of them the ERCP was unsuccessful. The effectiveness of
ERCP in the Digestive Endoscopy service was 79.2%. The main factor for surgical resolution was the calculus-common bile duct disproportion. The most frequent complications after ERCP were acute pancreatitis with 10.7% and hemorrhage with 1.7%. Conclusion: The effectiveness of endoscopic treatment of choledocholithiasis is high, leaving surgical resolution only for those special cases where stones are difficult to resolve, either due to their characteristics, anatomical variations of the bile
duct, history of previous surgery, among others.