Impact of bile duct stenting on the management of symptomatic choledocholithiasis: a retrospective multicenter analysis

ObjectiveCholedocholithiasis (CDL) can lead to various complications and requires treatment approaches for both biliary tract clearing and cholecystectomy. This study aims to characterize CDL patients, evaluate treatment strategies, assess associated complications, and explore economic impacts.Metho...

Full description

Saved in:
Bibliographic Details
Main Authors: Artur Rebelo, Marie L. Tischer, Jonas Rosendahl, Jens Walldorf, Tawfik Mosa, Jörg Kleeff, Johannes Klose
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Surgery
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2025.1630416/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850066904331321344
author Artur Rebelo
Marie L. Tischer
Jonas Rosendahl
Jens Walldorf
Tawfik Mosa
Jörg Kleeff
Johannes Klose
author_facet Artur Rebelo
Marie L. Tischer
Jonas Rosendahl
Jens Walldorf
Tawfik Mosa
Jörg Kleeff
Johannes Klose
author_sort Artur Rebelo
collection DOAJ
description ObjectiveCholedocholithiasis (CDL) can lead to various complications and requires treatment approaches for both biliary tract clearing and cholecystectomy. This study aims to characterize CDL patients, evaluate treatment strategies, assess associated complications, and explore economic impacts.MethodsWe conducted a retrospective analysis of 112 patients between 2016 and 2021 at two centers. We performed a descriptive analysis comparing outcomes of patients undergoing ERCP with and without bile duct stenting. Univariate and multivariable analyses were used to identify factors related to complications.ResultsBile duct stenting was associated with significantly higher complication rates (52.4%) compared to the group without stenting (26.5%) (p = 0.006). Factors influencing stent implantation included prior abdominal surgeries (OR = 03.51, p = 0.02), cholangitis at admission (OR = 03.02, p = 0.032), and bile duct diameter (OR = 01.16, p = 0.057). The overall median length of stay was longer for patients with stenting (19 days) compared to those without (11 days) (p < 0.001). Finally, reimbursements were higher for patients with stenting. Reimbursement for complicated courses was higher than for those without, independent of initial bile duct stenting (with stent p = 0.006, without stent p = 0,003).ConclusionBile duct stenting during CDL management is associated with higher complication rates, longer hospital stay, and increased costs. These associations may reflect both clinical severity at baseline and procedural sequencing. A more restrictive placement of biliary stents might be advisable.
format Article
id doaj-art-a07074dcee674727884e47ed74cfcdec
institution DOAJ
issn 2296-875X
language English
publishDate 2025-07-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Surgery
spelling doaj-art-a07074dcee674727884e47ed74cfcdec2025-08-20T02:48:34ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-07-011210.3389/fsurg.2025.16304161630416Impact of bile duct stenting on the management of symptomatic choledocholithiasis: a retrospective multicenter analysisArtur Rebelo0Marie L. Tischer1Jonas Rosendahl2Jens Walldorf3Tawfik Mosa4Jörg Kleeff5Johannes Klose6Department of Visceral, Vascular and Endocrine Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), GermanyDepartment of Visceral, Vascular and Endocrine Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), GermanyDepartment of Internal Medicine-I, Martin Luther University Halle-Wittenberg, Halle (Saale), GermanyDepartment of Internal Medicine-I, Martin Luther University Halle-Wittenberg, Halle (Saale), GermanyDepartment of Operative Medicine, Carl-von-Basedow-Hospital Saalekreis, Merseburg, GermanyDepartment of Visceral, Vascular and Endocrine Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), GermanyDepartment of Visceral, Vascular and Endocrine Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), GermanyObjectiveCholedocholithiasis (CDL) can lead to various complications and requires treatment approaches for both biliary tract clearing and cholecystectomy. This study aims to characterize CDL patients, evaluate treatment strategies, assess associated complications, and explore economic impacts.MethodsWe conducted a retrospective analysis of 112 patients between 2016 and 2021 at two centers. We performed a descriptive analysis comparing outcomes of patients undergoing ERCP with and without bile duct stenting. Univariate and multivariable analyses were used to identify factors related to complications.ResultsBile duct stenting was associated with significantly higher complication rates (52.4%) compared to the group without stenting (26.5%) (p = 0.006). Factors influencing stent implantation included prior abdominal surgeries (OR = 03.51, p = 0.02), cholangitis at admission (OR = 03.02, p = 0.032), and bile duct diameter (OR = 01.16, p = 0.057). The overall median length of stay was longer for patients with stenting (19 days) compared to those without (11 days) (p < 0.001). Finally, reimbursements were higher for patients with stenting. Reimbursement for complicated courses was higher than for those without, independent of initial bile duct stenting (with stent p = 0.006, without stent p = 0,003).ConclusionBile duct stenting during CDL management is associated with higher complication rates, longer hospital stay, and increased costs. These associations may reflect both clinical severity at baseline and procedural sequencing. A more restrictive placement of biliary stents might be advisable.https://www.frontiersin.org/articles/10.3389/fsurg.2025.1630416/fullsurgeryERCPcholecysititischolecystectomystent
spellingShingle Artur Rebelo
Marie L. Tischer
Jonas Rosendahl
Jens Walldorf
Tawfik Mosa
Jörg Kleeff
Johannes Klose
Impact of bile duct stenting on the management of symptomatic choledocholithiasis: a retrospective multicenter analysis
Frontiers in Surgery
surgery
ERCP
cholecysititis
cholecystectomy
stent
title Impact of bile duct stenting on the management of symptomatic choledocholithiasis: a retrospective multicenter analysis
title_full Impact of bile duct stenting on the management of symptomatic choledocholithiasis: a retrospective multicenter analysis
title_fullStr Impact of bile duct stenting on the management of symptomatic choledocholithiasis: a retrospective multicenter analysis
title_full_unstemmed Impact of bile duct stenting on the management of symptomatic choledocholithiasis: a retrospective multicenter analysis
title_short Impact of bile duct stenting on the management of symptomatic choledocholithiasis: a retrospective multicenter analysis
title_sort impact of bile duct stenting on the management of symptomatic choledocholithiasis a retrospective multicenter analysis
topic surgery
ERCP
cholecysititis
cholecystectomy
stent
url https://www.frontiersin.org/articles/10.3389/fsurg.2025.1630416/full
work_keys_str_mv AT arturrebelo impactofbileductstentingonthemanagementofsymptomaticcholedocholithiasisaretrospectivemulticenteranalysis
AT marieltischer impactofbileductstentingonthemanagementofsymptomaticcholedocholithiasisaretrospectivemulticenteranalysis
AT jonasrosendahl impactofbileductstentingonthemanagementofsymptomaticcholedocholithiasisaretrospectivemulticenteranalysis
AT jenswalldorf impactofbileductstentingonthemanagementofsymptomaticcholedocholithiasisaretrospectivemulticenteranalysis
AT tawfikmosa impactofbileductstentingonthemanagementofsymptomaticcholedocholithiasisaretrospectivemulticenteranalysis
AT jorgkleeff impactofbileductstentingonthemanagementofsymptomaticcholedocholithiasisaretrospectivemulticenteranalysis
AT johannesklose impactofbileductstentingonthemanagementofsymptomaticcholedocholithiasisaretrospectivemulticenteranalysis