title: Efficacy of spyglass-guided electrohydraulic lithotripsy in difficult bile duct stones.
abstract: OBJECTIVE
  We aimed to evaluate the efficacy and safety of Spyglass-guided electrohydraulic lithotripsy (EHL) for difficult common bile duct stones (CBD) not amenable to conventional endoscopic therapy.
  
  
  METHODS
  A retrospective study evaluating the efficacy of Spyglass-guided EHL in treating difficult CBD stones, in a single tertiary care center.
  
  
  METHODS
  All patients who underwent Spyglass-guided EHL from 2012 to 2013 were compared with a historical cohort who had ECSWL.
  
  
  RESULTS
  A total number of 13 patients underwent Spyglass-guided EHL, 8 (61.5%) of them were males. The mean age was 46.5 ± 5.6 years. Bile duct clearance was achieved in 13 (100%) of them. Seventy-six percent required only one Endoscopic Retrograde Cholangiopancreatography (ERCP) to clear the CBD, 7.7% required two ERCPs, and 15.4% required three ERCPs. Adverse effects (cholangitis) occurred in one patient (10%), whereas only 30 patients (64.4%) of the ESWL group had complete CBD stone clearance. Thirty-seven percent required one ERCP to clear the CBD, 35.6% required two ERCPs, and 20% required three ERCPs. Adverse effects happened in seven (15.5%) patients, where five (11%) had cholangitis and two (4.4%) had pancreatitis.
  
  
  CONCLUSIONS
  Although a retrospective design with a small sample size, we concluded that Spyglass-guided EHL is an effective procedure in treating difficult CBD stones.
authors.affiliation: Gastroenterology Division, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia, .
authors.forename: Abdulrahman M
authors.initials: AM
authors.lastname: Aljebreen
authors.forename: Othman R
authors.initials: OR
authors.lastname: Alharbi
authors.forename: Nahla
authors.initials: N
authors.lastname: Azzam
authors.forename: Majid A
authors.initials: MA
authors.lastname: Almadi
mesh_terms: D002760:Cholangiopancreatography, Endoscopic Retrograde; D042883:Choledocholithiasis / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome