Clinical Significance of Emergency EUS-Guided ERCP in the Treatment of Common Bile Duct Stones

Background and aim: Common bile duct stones (CBDS) can rapidly lead to cholangitis or biliary pancreatitis, making timely and accurate diagnosis essential. Although EUS provides high diagnostic accuracy, its value in emergency settings remains unclear. This study aimed to evaluate the clinical value of emergency EUS-guided ERCP. Methods A retrospective analysis was performed on the clinical data of 215 patients diagnosed with CBDS at the First Affiliated Hospital of Anhui Medical University between June 2018 and June 2024.Patients were assigned to either the emergency EUS group or the elective EUS group according to the time of symptom onset after admission and the time of EUS examination,Clinical efficacy, primary endpoint and secondary endpoint were compared between the two groups. Results Both the emergency and elective EUS groups achieved a 100% technical success rate for EUS and ERCP. The clinical success rates of ERCP were 96.3% and 94.8%, respectively, with no significant difference (P > 0.05). The emergency EUS group had significantly shorter hospital stays and lower hospitalization costs (P < 0.05). Post-ERCP complications were also significantly fewer in the emergency group (P < 0.05). No ICU admissions occurred in either group, and long-term complication rates were comparable (P > 0.05). Conclusion Emergency EUS-guided ERCP significantly reduces hospital stay and hospitalization costs in patients with CBDS.It reduces the risk of short-term postoperative complications following ERCP but does not decrease the incidence of long-term postoperative complications.Therefore, emergency EUS-guided ERCP may serve as an effective strategy for patients presenting with acute CBDS, primarily by improving short-term clinical outcomes.