Clearance Rate of Common Bile Duct During First ERCP Attempt in Patients with Choledocholithiasis at a Tertiary Care Hospital


  • Author- Asma Nizam, Farwah Javed, Ghias Ul Hassan, Hafiz Habib Ur Rehman Khalil, Hafiz Hafeez Anjum, Muhammad Usman Khan


Objective: The aim of this study was to determine clearance rate of common bile duct stone during first ERCP attempt in patients with choledocholithiasis at a tertiary care hospital.


This was a retrospective study conducted from January 2017 to December 2020 at department of Gastroenterology, Lahore General Hospital. All the patient with naive papilla who had common bile duct stone on the basis of ultrasonography/ CT/ MRCP were included in the study. Data were retrieved from the endoscopic suite database. Information regarding patient's demographics and clinical variables like age, gender along with the number of CBD stones, CBD width, existence of periampullary diverticula, impaction of the stone and sphincter management, stone removal methods and stone clearance rate were noted. Statistical Package for Social Sciences (SPSS) version 24 was used for the purpose of statistical analysis. P-value <0.05 was taken as significant.


 We retrospectively reviewed the data of 496 patients, who had undergone ERCP for choledocholithiasis. The mean age of patients was 49.18 ±14.70 years. There were 336 (67.7%) females and 160 (32.3%) males. Two hundred sixty (52.4%) patients had single stone, while remaining 236 (47.6%) had multiple stones. In 422 (85.1%) patients, cannulations with wire were achieved, fifty-two (10.5%) patients underwent cannulation with double wire technique, and 17 (3.4%) underwent precut cannulation. Out of 496 patients, sphincterotomy was done in 495 (99.8%) and sphincteroplasty with CRE balloon dilatation was done in 228 (46%) patients. Stone was successfully retrieved during first ERCP in 421 (84.9%), unsuccessful ERCP in 72 (14.3%) and 3 patients had to undergo surgery. Accessories used for stone extraction were balloon, dormia basket and cholangioscopy in 482 (97.2%), 10 (2%) and 4 (0.8%) patients respectively


 During initial attempts at ERCP, the stone extraction rate typically is around 84.9%. This is largely dependent on the proficiency of the performing physician.


ERCP, Common bile ducts SPSS