Transcystic Duct Gallbladder-preserving Cholecystolithotomy by ERCP: Efficacy in Managing Cholecystolithiasis With or Without Common Bile Duct Stones

Objective: This study aims to assess the efficacy of transcystic duct gallbladder-preserving cholecystolithotomy by endoscopic retrograde cholangiopancreatography (TDGPCE) in patients diagnosed with cholecystolithiasis, both in the presence and absence of common bile duct stones (CBDS). Methods: A total of 54 patients with cholecystolithiasis, including those with and without CBDS, who underwent TDGPCE between March 2021 and May 2024 at the Endoscopy Center of Shenzhen University General Hospital were enrolled in this study. Clinical data and follow-up results were documented for all patients. Results: Gallbladder stones were successfully removed in 45 patients (83.3%) by TDGPCE. Comparisons of the success rate of stone removal, operative time, and full-covering metal stent (FCMS) placement time revealed no significant differences between patients with cholecystolithiasis, regardless of CBDS presence ( P >0.05). Post-ERCP pancreatitis (n=3, 6.7%) and hyperamylasemia (n=21, 46.7%) were resolved with subsequent interventions. Notably, the 3 patients who developed post-ERCP pancreatitis did not receive pancreatic duct stent insertion due to the presence of an accessory pancreatic duct. Concomitant CBDS did not correlate with an increased risk of post-ERCP pancreatitis or hyperamylasemia in patients undergoing TDGPCE ( P >0.05). During the follow-up period, among the patients (n=45) who underwent this procedure, one reported residual gallbladder stones, and 2 experienced recurrence of gallbladder stones. Conclusion: TDGPCE is a safe and effective approach for the removal of gallbladder stones in patients with cholecystolithiasis, offering the advantage of preserving gallbladder function without the need for incisions to the abdominal wall or gastrointestinal tract.