Influence of night duty on endoscopic therapy for bile duct stones

Table 1 Profile of endoscopists

Item	ND Group	DD Group	P value
	(n = 34)	(n = 99)
Endoscopists (years of experience)			0.527
A (14-19)	5	11
B (6-9)	7	17
C (6-8)	8	21
D (6-11)	5	16
E (7-12)	2	22
F (10-15)	3	7
G (5-8)	3	4
H (3-7)	1	1
Years of experience, mean ± SD	9.3 ± 3.9	9.4 ± 3.4	0.830

ND: Night duty; DD: Day duty.

Table 2 Comparison of patient characteristics

	ND Group	DD Group	P value
	(n = 34)	(n = 99)
Age (yr), mean ± SD	73.1 ± 13.0	72.4 ± 14.3	0.801
Gender (M/W)	21/13	59/40	0.824
History of abdominal surgery, n (%)	7 (20.6)	18 (18.2)	0.757
Double tract reconstruction, n		1
Billroth I		3
Billroth II	4	6
Roux-en-Y	3	7
Duodenoduodenostomy		1
Transverse diameter of the largest stone (mm), mean ± SD	10.6 ± 4.6	10.3 ± 4.9	0.735
Number of stones, mean ± SD	2.8 ± 4.0	2.8 ± 3.6	1.0

ND: Night duty; DD: Day duty; Double tract reconstruction: Double tract reconstruction for proximal gastrectomy; Duodenoduodenostomy: Duodenoduodenostomy for annular pancreas.

Table 3 Comparison of endoscopic procedures, n (%)

	ND Group	DD Group	P value
	(n = 34)	(n = 99)
EST	32 (94.1)	83 (83.8)	0.107
EPBD	0 (0)	6 (6.1)	0.163
EPLBD	16 (47.1)	19 (19.2)	0.001

ND: Night duty; DD: Day duty; EST: Endoscopic sphincterotomy; EPBD: Endoscopic papillary balloon dilation; EPLBD: Endoscopic papillary large balloon dilation.

Table 4 Comparison of treatment outcomes n (%)

	ND Group	DD Group	P value
	(n = 34)	(n = 99)
Procedure time (min), mean ± SD	71.5 ± 44.7	54.2 ± 28.8	0.043
Rate of stone removal by first endoscopist	13 (38.2)	52 (52.5)	0.150
Procedure success rate by first endoscopist	18 (52.9)	57 (57.6)	0.638
Rate of final stone removal	24 (70.6)	66 (66.7)	0.67
Final procedure success rate	33 (97.1)	90 (90.9)	0.22
Complications	1 (2.9)	11 (11.1)	0.136
Pancreatitis	1	6
Duodenal bleeding		2
Decreased blood pressure		1
Hypoxia		2
Hospitalization after procedure (d), mean ± SD	7.1 ± 7.6	6.6 ± 6.6	0.715

ND: Night duty; DD: Day duty; Procedure success rate: Removal of stones or biliary stenting.

Table 5 Comparison of treatment outcomes for each endoscopist n (%)

	ND Group	DD Group	P value
Endoscopist A
n	5	11
Procedure time (min), median ± SD	90.0 ± 80.8	90.0 ± 39.7	0.910
Rate of stone removal	3 (60.0)	6 (54.5)	0.635
Procedure success rate	5 (100)	9 (81.8)	0.458
Endoscopist B
n	7	17
Procedure time (min), median ± SD	40.0 ± 20.4	50.0 ± 26.0	0.589
Rate of stone removal	5 (71.4)	11 (64.7)	0.572
Procedure success rate	5 (71.4)	12 (70.6)	0.607
Endoscopist C
n	8	21
Procedure time (min), median ± SD	75.0 ± 39.6	50.0 ± 27.1	0.113
Rate of stone removal	3 (37.5)	7 (33.3)	0.745
Procedure success rate	4 (50.0)	10 (47.6)	0.617
Endoscopist D
n	5	16
Procedure time (min), median ± SD	60 ± 31.5	40 ± 14.7	0.017
Rate of stone removal	1 (20)	8 (50)	0.258
Procedure success rate	1 (20)	10 (62.5)	0.126

ND: Night duty; DD: Day duty; Procedure success rate: Removal of stones or biliary stenting.

Table 6 Reasons for not performing endoscopic papillary large balloon dilation

	ND Group	DD Group	P value
	(n = 34)	(n = 99)
Patients with EPLBD indication, n (%)	20 (58.8)	44 (44.4)	0.15
Patients in whom EPLBD was performed (shown in Table 3)	16	19
Reasons for not performing EPLBD
AOSC	1	5
Narrow lower bile duct	1	1
Biliary stricture	1	0
Minor bleeding of Vater’s papilla	1	0
No insurance coverage for EPLBD	0	5
96 years old and performance status 3	0	1
Gallstone pancreatitis	0	3
Antithrombotic drug therapy	0	4
Difficulty identifying the biliary anastomotic region	0	2
Smaller stones on visual inspection	0	2
Difficulty identifying the Vater papilla	0	1
Double tract reconstruction	0	1

EPLBD: Endoscopic papillary large balloon dilation; AOSC: Acute obstructive suppurative cholangitis.