Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 14, 2016; 22(42): 9387-9393
Published online Nov 14, 2016. doi: 10.3748/wjg.v22.i42.9387
Influence of night duty on endoscopic therapy for bile duct stones
Mitsuru Sugimoto, Tadayuki Takagi, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Yuichi Waragai, Mika Takasumi, Takuto Hikichi, Hiromasa Ohira
Mitsuru Sugimoto, Tadayuki Takagi, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Yuichi Waragai, Mika Takasumi, Hiromasa Ohira, Department of Gastroenterology and Rheumatology, Fukushima Medical University, School of Medicine, Fukushima City 960-1247, Fukushima, Japan
Naoki Konno, Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Takuto Hikichi, Department of Endoscopy, Fukushima Medical University Hospital, Fukushima City 960-1247, Fukushima, Japan
Author contributions: Sugimoto M designed the research; Sugimoto M performed the research; Sugimoto M, Takagi T and Ohira H analyzed the data; Sugimoto M, Takagi T, and Ohira H wrote the paper; Takagi T, Suzuki R, Konno N, Asama H, Hikichi T, Watanabe K, Nakamura J, Kikuchi H, Waragai Y and Takasumi M provided clinical advice; Hikichi T and Ohira H supervised the report.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Fukushima Medical University Hospital.
Informed consent statement: Patients were not required to provide informed consent for this study because the analysis utilized anonymous clinical data that were obtained after each patient agreed to treatment by written consent. For full disclosure, the details of the study are published on the home page of Fukushima Medical University.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr.Tadayuki Takagi, Associate Professor, Department of Gastroenterology and Rheumatology, Fukushima Medical University, School of Medicine, 1 Hikarigaoka, Fukushima City 960-1247, Fukushima, Japan. daccho@fmu.ac.jp
Telephone: +81-24-5471202 Fax: +81-24-5472055
Received: June 21, 2016
Peer-review started: June 22, 2016
First decision: August 22, 2016
Revised: September 6, 2016
Accepted: October 10, 2016
Article in press: October 10, 2016
Published online: November 14, 2016
Abstract
AIM

To examine the influence of night duty (ND) on endoscopic therapy for biliary duct stones.

METHODS

The subjects consisted of 133 patients who received initial endoscopic therapy for biliary duct stones performed by eight endoscopists after they had been on (ND group, n = 34 patients) or not [day duty (DD) group, n = 99 patients]. Patient characteristics (age, gender, history of abdominal surgery, transverse diameter of the largest stone, number of stones), years of experience of the endoscopists, endoscopic procedures [sphincterotomy, papillary balloon dilation (EPBD), papillary large balloon dilation (EPLBD)], and outcomes of initial endoscopy (procedure time; rate of stone removal by the first endoscopist; procedure success rate by the first endoscopist: removal of stones or endoscopic retrograde biliary drainage; rate of final stone removal; final procedure success rate; complications; hospitalization after the procedure) were compared retrospectively between the two groups. History of abdominal surgery and treatment outcomes were also compared between the groups for each of the four endoscopists who performed most of the procedures in the ND group.

RESULTS

There were no significant differences regarding the number of treatments performed by each endoscopist or the years of experience between the ND and DD groups. The frequency of endoscopic retrograde cholangiopancreatography procedures did not differ significantly between the groups. There were also no significant differences regarding patient characteristics: age, gender, history of abdominal surgery (ND 7: Billroth II 4, R-Y 3; DD 18: double tract reconstruction 1, Billroth I 3, Billroth II 6, R-Y 7, duodenoduodenostomy for annular pancreas 1), transverse diameter of largest stone, and number of stones between the two groups. Among the treatment procedures, the endoscopic sphincterotomy and EPBD rates did not differ significantly between the groups. However, EPLBD was performed more frequently in the ND group [47.1% (16/34) vs 19.2% (19/99)]. Regarding outcomes, there were no significant differences in the rate of stone removal, procedure success rate, complications (ND: pancreatitis 1; DD: pancreatitis 6, duodenal bleeding 1, decreased blood pressure 1, hypoxia 2), or hospitalization after the procedure. However, the procedure time was significantly longer in the ND group (71.5 ± 44.7 vs 54.2 ± 28.8). Among the four endoscopists, there were no significant differences in patient history of abdominal surgery, removal of stones, or procedure success rate. However, the procedure time for one endoscopist was significantly longer in the ND group.

CONCLUSION

The time required for endoscopic therapy for bile duct stones might be influenced by ND.

Keywords: Night duty, Endoscopic therap, Bile duct stone, Removal of stones, Procedure time

Core tip: Sleep deprivation affects brain activation, and therefore disturbs cognitive ability and reduces work efficiency. In the clinical field, night duty (ND) might affect surgical outcomes and the number of medical errors. In this study, we examined the influence of ND on endoscopic therapy for biliary duct stones. The procedure was significantly longer when performed by endoscopists after they had been on ND. The time required for endoscopic therapy for bile duct stones might be influenced by ND.