title: Effect of ursodeoxycholic acid and endoscopic sphincterotomy in long-term stenting for common bile duct stones.
abstract: OBJECTIVE
  We investigated the patency rate of a biliary stent and the effects of ursodeoxycholic acid (UDCA) therapy and endoscopic sphincterotomy (EST) for difficult-to-remove common bile duct stones.
  
  
  METHODS
  A total of 63 endoscopic retrograde cholangiopancreatographies (ERCPs) were performed in 36 patients (mean age, 86.0 years; male-female, 17:19) for stenting. Among the 63 subjects, 28 were further treated with EST; 20, with UDCA therapy; and 43, without UDCA therapy.
  
  
  RESULTS
  The mean patency time was significantly longer in the UDCA treatment group (1,012 days) than in the "stent without UDCA" group (354 days; P = 0.0002; hazard ratio, 0.253). The mean patency time was significantly longer in the patients who had stent placement with EST (1074 days) than in those who had stent placement without EST (279 days; P = 0.001; hazard ratio, 0.439). The mean patency time was significantly longer in the patients who had stent placement with UDCA therapy and EST (1211 days) than in the patients who had stent placement with either UDCA therapy or EST (425 days; P = 0.031; hazard ratio, 0.3292). The mean patency time was significantly longer in the patients who had stent placement with either UDCA therapy or EST than in those who had stent placement without UDCA therapy or EST (263 days; P = 0.0465; hazard ratio, 0.5124).
  
  
  CONCLUSIONS
  Biliary stenting combined with UDCA therapy and EST may be considered as an effective treatment method for cases of common bile duct stones in elderly patients that are difficult to remove.
authors.affiliation: Division of Gastroenterology, National Hospital Organization Tokyo Medical Center, Meguro-ku, Tokyo, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Nishizawa
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Suzuki
authors.forename: Masahiko
authors.initials: M
authors.lastname: Takahashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kaneko
authors.forename: Masayuki
authors.initials: M
authors.lastname: Suzuki
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Hibi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002756:Cholagogues and Choleretics / Q000627:therapeutic use*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003131:Combined Modality Therapy; D005260:Female; D042882:Gallstones / Q000628:therapy*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic; D015607:Stents; D013997:Time Factors; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use*
chemical_list: D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid