The value of endoscopic duodenal papilloplasty with titanium clip in improving post-operative complications of choledocholithiasis




Xuan Zhao, Department of Gastroenterology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
Lihong Shi, Department of Gastroenterology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
Jinchen Wang, Department of Gastroenterology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
Siming Guo, Department of Gastroenterology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
Sumin Zhu, Department of Gastroenterology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, China


Objective: To investigate the value of endoscopic duodenal papillary sphincterotomy combined with balloon dilatation in the treatment of duodenal papilloplasty with titanium clip after choledocholithiasis in post-operative complications. Materials and methods: One hundred and twenty-five patients (69 males and 56 females) with a median age of 65 (32-81) years were included. The treatment plan was randomly divided into Group A (n = 59) and Group B (n = 66) according to the random number table. Patients in Group A were treated with endoscopic sphincterotomy (EST) combined with endoscopic papillary large balloon dilation (EPLBD), followed by a titanium clip for duodenal papilloplasty and then indwelling nasobiliary drainage, whereas those in Group B were treated with EST combined EPLBD to remove stones and then indwelling nasobiliary drainage. Results: In patients with choledocholithiasis or with anatomical changes that make stone extraction difficult, this prospective study attempted to perform duodenal papilloplasty with titanium clips after EST and EPLBD lithotripsy to compare and observe post-operative papillary healing, biliary reflux, and complication rates. Conclusions: The use of endoscopic duodenal papilloplasty with a titanium clip can improve biliary reflux after lithotripsy and reduce the incidence of post-operative cholangitis complications.



Keywords: Titanium clip. Plastic surgery of duodenal papilla. Common bile duct stones. Complication. Cholangitis. Biliary tract reflux.