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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">JPSIM</journal-id>
      <journal-title-group>
        <journal-title>Journal of Pakistan Society of Internal Medicine</journal-title>
        <abbrev-title>J Pak Soc Intern Med</abbrev-title>
      </journal-title-group>
      <issn publication-format="print">2709-8729</issn>
      <issn publication-format="electronic">2710-0804</issn>
      <publisher>
        <publisher-name>Pakistan Society of Internal Medicine</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="doi">10.70302/jpsim.v5i2.2432</article-id>
      <article-id pub-id-type="publisher-id">jpsim.v5i2.2432</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Original Research</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Clearance Rate of Common Bile Duct During First ERCP Attempt in Patients with Choledocholithiasis at a Tertiary Care Hospital</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author" corresp="yes">
          <name>
            <surname>Nizam</surname>
            <given-names>Asma</given-names>
          </name>
          <email>asmanaveed_2009@yahoo.com</email>
          <xref ref-type="aff" rid="aff1"/>
          <xref ref-type="corresp" rid="cor1">*</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Javed</surname>
            <given-names>Farwah</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Hassan</surname>
            <given-names>Ghias Ul</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Khalil</surname>
            <given-names>Hafiz Habib Ur Rehman</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Anjum</surname>
            <given-names>Hafiz Hafeez</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Khan</surname>
            <given-names>Muhammad Usman</given-names>
          </name>
          <xref ref-type="aff" rid="aff2"/>
        </contrib>
      </contrib-group>
      <aff id="aff1">
        <institution>Allowdin Medical College Lahore General Hospital, Lahore</institution>
      </aff>
      <aff id="aff2">
        <institution>Allama Iqbal Teaching Hospital DG Khan</institution>
      </aff>
      <author-notes>
        <corresp id="cor1">*Correspondence: Asma Nizam (asmanaveed_2009@yahoo.com)</corresp>
      </author-notes>
      <pub-date date-type="pub" publication-format="electronic" iso-8601-date="2024-06-07">
        <day>07</day>
        <month>06</month>
        <year>2024</year>
      </pub-date>
      <pub-date date-type="collection" publication-format="electronic">
        <year>2024</year>
      </pub-date>
      <volume>5</volume>
      <issue>2</issue>
      <fpage>511</fpage>
      <lpage>515</lpage>
      <history>
        <date date-type="received" iso-8601-date="2024-01-23">
          <day>23</day>
          <month>01</month>
          <year>2024</year>
        </date>
        <date date-type="accepted" iso-8601-date="2024-04-01">
          <day>01</day>
          <month>04</month>
          <year>2024</year>
        </date>
      </history>
      <permissions>
        <copyright-statement>Copyright © 2024 The Author(s)</copyright-statement>
        <copyright-year>2024</copyright-year>
        <copyright-holder>The Author(s)</copyright-holder>
        <ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/>
        <license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/">
          <ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by/4.0/</ali:license_ref>
          <license-p>This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
        </license>
      </permissions>
      <self-uri xlink:href="https://psimj.com/article/jpsim.v5i2.2432" content-type="text/html"/>
      <self-uri xlink:href="https://psimj.com/article/jpsim.v5i2.2432.pdf" content-type="application/pdf"/>
      <abstract>
        <sec>
          <title>Objective</title>
          <p>The aim of this study was to determine clearance rate of common bile duct stone during first ERCP attempt in</p>
          <p>patients with choledocholithiasis at a tertiary care hospital.</p>
        </sec>
        <sec>
          <title>Methodology</title>
          <p>This was a retrospective study conducted from January 2017 to December 2020 at department of Gastroenterology,</p>
          <p>Lahore General Hospital. All the patient with naive papilla who had common bile duct stone on the basis of ultrasonography/</p>
          <p>CT/ MRCP were included in the study. Data were retrieved from the endoscopic suite database. Information regarding</p>
          <p>patient's demographics and clinical variables like age, gender along with the number of CBD stones, CBD width, existence of</p>
          <p>periampullary diverticula, impaction of the stone and sphincter management, stone removal methods and stone clearance</p>
          <p>rate were noted. Statistical Package for Social Sciences (SPSS) version 24 was used for the purpose of statistical analysis.</p>
          <p>P-value</p>
        </sec>
        <sec>
          <title>Results</title>
          <p>We retrospectively reviewed the data of 496 patients, who had undergone ERCP for choledocholithiasis. The</p>
          <p>mean age of patients was 49.18 ±14.70 years. There were 336 (67.7%) females and 160 (32.3%) males. Two hundred sixty</p>
          <p>(52.4%) patients had single stone, while remaining 236 (47.6%) had multiple stones. In 422 (85.1%) patients, cannulations</p>
          <p>with wire were achieved, fifty-two (10.5%) patients underwent cannulation with double wire technique, and 17 (3.4%)</p>
          <p>underwent precut cannulation. Out of 496 patients, sphincterotomy was done in 495 (99.8%) and sphincteroplasty with</p>
          <p>CRE balloon dilatation was done in 228 (46%) patients. Stone was successfully retrieved during first ERCP in 421</p>
          <p>(84.9%), unsuccessful ERCP in 72 (14.3%) and 3 patients had to undergo surgery. Accessories used for stone extraction</p>
          <p>were balloon, dormia basket and cholangioscopy in 482 (97.2%), 10 (2%) and 4 (0.8%) patients respectively.</p>
        </sec>
        <sec>
          <title>Conclusion</title>
          <p>During initial attempts at ERCP, the stone extraction rate typically is around 84.9%. This is largely dependent</p>
          <p>on the proficiency of the performing physician</p>
        </sec>
      </abstract>
      <kwd-group xml:lang="en" kwd-group-type="author-keywords">
        <title>Keywords</title>
        <kwd>ERCP</kwd>
        <kwd>Common bile ducts SPSS</kwd>
      </kwd-group>
    </article-meta>
  </front>
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