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This study aims to compare EUS-guided treatment and BE-ERCP for removing large bile duct stones in patients with surgically altered anatomy.

July 10, 2026Endoscopic UltrasoundOpen Access

Comparison of EUS-guided treatment and balloon-enteroscopy-assisted endoscopic retrograde cholangiopancreatography for large bile duct stone removal in patients with surgically altered anatomy: A multicenter study

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This study aims to compare EUS-guided treatment and BE-ERCP for removing large bile duct stones in patients with surgically altered anatomy.
Multicenter retrospective study including patients with surgically altered anatomy (SAA) undergoing EUS-T or BE-ERCP between January 2016 and February 2025.
Primary outcome measured was complete stone removal rate; secondary outcomes included sessions needed, procedure time, and adverse events.
Propensity score matching was used to balance baseline differences between groups.
EUS-T had a complete stone removal rate of 90.5% compared to 61.9% for BE-ERCP (P = 0.030).
The average number of sessions for EUS-T was higher at 2.1 compared to 1.2 for BE-ERCP (P < 0.001).
Mean procedure times and adverse events were similar between EUS-T and BE-ERCP.

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Multicenter study compares EUS-guided treatment and BE-ERCP for bile duct stone removal in altered anatomy, suggesting EUS-T is preferable.

Sagami et al. (2026) studied this question.

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Multicenter study compares EUS-guided treatment and BE-ERCP for bile duct stone removal in altered anatomy, suggesting EUS-T is preferable.