{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:40:31Z","timestamp":1777448431789,"version":"3.51.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T00:00:00Z","timestamp":1751500800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Choledocholithiasis is a common biliary tract disease that requires effective intervention. This study aimed to evaluate the effectiveness of transduodenal choledochoscopy stone extraction and analyze its impact on postoperative complications in a prospective cohort of patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective study was conducted on 186 patients with choledocholithiasis who underwent transduodenal choledochoscopy stone extraction between January 2022 and December 2023. Patients were evaluated for operative success rate, stone clearance rate, and postoperative complications. Stone characteristics, technical aspects, quality of life outcomes, and cost-effectiveness were assessed. Follow-up was conducted for 6 months post-procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The overall stone clearance rate was 94.6% (176\/186), with complete stone removal achieved in a single session in 82.8% of cases (154\/186). Mean operation time was 45.3 \u00b1 15.7 min. Basket extraction was the primary method (52.7%), followed by balloon extraction (24.2%) and mechanical lithotripsy (23.1%). Postoperative complications occurred in 11.8% of patients, including pancreatitis (3.2%), cholangitis (2.7%), bleeding (1.6%), and minor complications (4.3%). The stone recurrence rate during the 6-month follow-up period was 4.3%, with a mean time to recurrence of 4.2 \u00b1 1.3 months. Multivariate analysis revealed that stone size &gt;15\u00a0mm (OR: 2.34, 95% CI: 1.45-3.78,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), multiple stones (OR: 1.89, 95% CI: 1.23-2.91,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003), and intrahepatic location (OR: 1.76, 95% CI: 1.12-2.77,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.014) were independent risk factors for procedural failure. Quality of life scores showed significant improvement across all SF-36 domains (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Mean procedure-related costs were $2845 \u00b1 625, with additional costs of $986 \u00b1 423 for managing complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Transduodenal choledochoscopy stone extraction demonstrates high effectiveness with acceptable complication rates. The technique proves particularly suitable for patients with stones smaller than 15\u00a0mm and shows advantages in terms of single-session success rates and long-term stone clearance. While initial costs and operator experience may pose challenges, reduced radiation exposure and lower need for re-intervention highlight its clinical value. While associated with higher initial costs, the procedure may be cost-effective due to reduced need for repeat interventions and improved quality of life outcomes. Careful patient selection based on stone characteristics and anatomical factors is crucial for optimal outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348251346540","type":"journal-article","created":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T01:19:29Z","timestamp":1751591969000},"page":"146-153","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Study on the Effectiveness of Choledochoscopic Stone Extraction and Its Impact on Patient Complications"],"prefix":"10.1177","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7435-2807","authenticated-orcid":false,"given":"Zeling","family":"Li","sequence":"first","affiliation":[{"name":"The First People\u2019s Hospital of Jingdezhen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongyang","family":"Li","sequence":"additional","affiliation":[{"name":"The First People\u2019s Hospital of Jingdezhen"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,7,3]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.21037\/atm-21-6186"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-023-07981-7"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.10.017"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v27.i28.4536"},{"key":"e_1_3_5_6_2","volume-title":"Treatment of complicated gallstones in elderly patients [dissertation]","author":"Kivivuori A","year":"2024","unstructured":"Kivivuori A. Treatment of complicated gallstones in elderly patients [dissertation]. University of Eastern Finland; 2024."},{"issue":"9","key":"e_1_3_5_7_2","first-page":"148","article-title":"The treatment of gallstone disease","volume":"117","author":"Gutt C","year":"2020","unstructured":"Gutt C, Schl\u00e4fer S, Lammert F. The treatment of gallstone disease. Dtsch Arztebl Int. 2020;117(9):148-158.","journal-title":"Dtsch Arztebl Int"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-022-09723-8"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.4253\/wjge.v13.i12.571"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.3904\/kjim.2020.425"},{"issue":"8","key":"e_1_3_5_11_2","first-page":"707","article-title":"Comparison of stone extraction under direct visualization with a single peroral choledochoscopy system and conventional X-ray endoscopic retrograde cholangiopancreatography for non-difficult common bile duct stones","volume":"40","author":"Wang L","year":"2023","unstructured":"Wang L, Jiang G, Lu X, et al. Comparison of stone extraction under direct visualization with a single peroral choledochoscopy system and conventional X-ray endoscopic retrograde cholangiopancreatography for non-difficult common bile duct stones. Chin J Dig Endosc. 2023;40(8):707-712.","journal-title":"Chin J Dig Endosc"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-71731-2"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/9781119601111.ch24"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003755"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-018-6170-8"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2016.12.021"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2009.10.027"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2020.02.003"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2021.05.005"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1590\/0102-672020190001e1491"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1055\/a-0862-0346"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(00)70286-0"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251346540","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348251346540","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251346540","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:37:55Z","timestamp":1777379875000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348251346540"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,3]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1177\/00031348251346540"],"URL":"https:\/\/doi.org\/10.1177\/00031348251346540","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,3]]}}}