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National Survey Regarding the Management of Difficult Bile Duct Stones in South Korea

Authors
Lee, Yoon SukJeon, Tae JooPaik, Woo HyunAhn, Dong-WonChung, Kwang HyunSon, Byoung KwanSong, Tae JunMoon, Sung-HoonLee, Eaum SeokLee, Jae MinYoon, Seung BaePaik, Chang NyolLee, Yun NahPark, Jin-SeokLee, Dong WookPark, Sang WookChon, Hyung KuCho, Kwang BumPark, Chang HwanCommittee of Policy and Quality Management in Korean Pancreatobiliary Association
Issue Date
Jul-2022
Publisher
거트앤리버 발행위원회
Keywords
Bile ducts; Gallstones; Endoscopy; Cholangiopancreatography endoscopic retrograde; Surveys and questionnaires
Citation
Gut and Liver
Indexed
SCIE
SCOPUS
KCI
Journal Title
Gut and Liver
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/61344
DOI
10.5009/gnl220117
ISSN
1976-2283
Abstract
Background/Aims: This study aimed to investigate the patterns of preferred endoscopic procedure 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 Association (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 endoscopic 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 doubleguidewire 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 improvements in the management of difficult CBD stones.
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Lee, Jae Min
Anam Hospital (Department of Gastroenterology and Hepatology, Anam Hospital)
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