Endoscopic treatment of choledocholithiasis in patients with metabolic syndrome

Aim. To study the results of endoscopic treatment of choledocholithiasis in patients with metabolic syndrome.

Material and methods. A total of 49 patients with choledocholithiasis and metabolic syndrome were studied between 2021 and 2023. The patients were between 36 and 82 years old. There were 12 men and 37 women among the patients studied. Of the 49 patients who underwent surgery, 9 were admitted for elective surgery. These patients were diagnosed with choledocholithiasis without obstructive jaundice and chronic calculous cholecystitis. The remaining 40 patients were admitted on an emergency basis. All patients underwent endoscopic retrograde cholangiopancreatography (ERCP) using the FUJIFILM ED-580XT duodenoscope and Mobile Surgical C-ARM X-ray systems.

Results. Endoscopic retrograde cholangiopancreatography and endoscopic papilosphincterotomy were performed under endotracheal anaesthesia in standard left lateral decubitus position. The average duration of surgery was 39±9.3 minutes. Postoperative complications were noted in 5 (%) patients and included bleeding from a papiltomous wound in 2 patients and postoperative pancreatitis in 3 patients. The average length of hospital stay after ERCP EPST was 2.6±1.6 bed days. The condition of the patients before and after surgery was satisfactory, haemodynamics were stable. No fatal outcomes were noted in the postoperative period.

Conclusion. Endoscopic treatment of choledocholithiasis in patients with metabolic syndrome allows one to avoid the use of traumatic traditional approaches and perform the operation completely, even in cases where laparoscopic surgery is contraindicated.

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