Đánh giá kết quả điều trị viêm đường mật cấp do sỏi ống mật chủ ở bệnh nhân cắt dạ dày nối Billroth II bằng nội soi mật tụy ngược dòng tại Bệnh viện Trung ương Quân đội 108

Background: Endoscopic Retrograde Cholangiopancreatography (ERCP) is a challenging procedure for endoscopists when treating patients with acute cholangitis caused by common bile duct stones (CBDS) who have undergone Billroth II gastrectomy due to anatomical changes in the digestive tract. The success of this procedure depends on the endoscopic instruments used and the endoscopist's experience. Objectives: In this study, we evaluated the effectiveness and safety of ERCP for treating acute cholangitis caused by CBDS in patients with previous Billroth II gastrectomy. Subjects and methods: We conducted the study on 42 patients with acute cholangitis caused by CBDS who had undergone Billroth II gastrectomy and were treated by ERCP at 108 Military Central Hospital between June 2018 and July 2022. Results: The study included 42 patients with an average age of 75.3 ± 11.6 years, with a male-to-female ratio of 2.5/1. Of these patients, 90.5% (38/42) had a history of Billroth II gastrectomy due to previous benign diseases, and 85.7% (36/42) of patients had undergone Billroth II gastrectomy for over 5 years. The successful intubation rate was 88.1% (37/42), and 73% of patients had their stones removed during the first intervention. The rate of performed gastric endoscopes and lateral view endoscopes was 67.6% and 32.4%, respectively. The proportion of endoscopic papillary large balloon dilation was 89.2%. The rate of complications after the intervention was as follows: acute pancreatitis (9.4%), gastrointestinal bleeding (4.8%), and small bowel perforation (2.4%). No deaths were reported. Conclusion: The results of our study suggest that ERCP for CBDS extraction can be feasible and safe in patients with Billroth II anatomy.