IDDF2024-ABS-0447 ERCP-based transcystic duct gallbladder-preserving cholecystolithotom for cholecystolithiasis patients with or without common bile duct stones

Background Cholecystolithiasis is a common digestive disorder worldwide, affecting 7% of adults aged 20-74 years. In this study, we evaluated the performance of ERCP-based transcystic duct gallbladder-preserving cholecystolithotom for patients having cholecystolithiasis with or without common bile duct stones. Methods A total of 54 patients having cholecystolithiasis with or without common bile duct stones (CBDs) and treated with ERCP-based transcystic duct gallbladder-preserving cholecystolithotom were enrolled in this study from March 2021-May 2024 at endoscopy center, Shenzhen University General Hospital. Results The mean age of the 54 patients is 44.8±14.4years; 34 (63.0%) are male, and 20 (37.0%) are female; 18 (33.3%) patients had CBDs, while the rest 36 (66.7%) did not. Forty-five (83.3%) patients had their gallbladder stones removed by ERCP, 3 (33.3%) patients achieved cholecystolithotom by NOTEs, and 6 (66.7%) patients required additional LC. The success rate of stone removal (83.3% vs. 83.3%, p=1.000), operation time (258.5±146.9min vs. 257.2±145.4min, p=0.971), and full-covering metal stent (FCMS) implantation time (61.8±26.7 min vs. 61.9±48.7 min, p=0.360) were similar between cholecystolithiasis patients with or without CBDs. Reported adverse events include post-ERCP pancreatitis (n=3, 6.7%) and hyperamylasemia (n=24, 53.3%), which were resolved by subsequent intervention. The 3 patients with post-ERCP pancreatitis did not receive pancreatic duct stent insertion. Interestingly, we found the insertion of a pancreatic duct stent did not decrease the incidence of post-ERCP hyperamylasemia (57.1% vs. 62.5%, p=0.714). CBDs did not increase the incidence of post-ERCP pancreatitis (6.7% vs. 6.7%, p=1.000) or hyperamylasemia (56.7% vs. 46.7%, p=0.526). Patients (n=45) who underwent this operation were followed up for 2-31 months (9.7±7.6). Among them, 1 reported residual gallbladder stones 1 month post-operation, 1 reported sandy stones 21 months post-operation, and 1 had recurrence of gallbladder stones 5 months post-operation. Conclusions ERCP-based transcystic duct gallbladder-preserving cholecystolithotom is safe and effective for the treatment of cholecystolithiasis. It preserves gallbladder function and is effective for cholecystolithiasis with or without CBDs.