Complications increase in which type of duodenal diverticulum? A retrospective cohort study

Akaydın, Murat; Akay, Tamer; Leblebici, Metin

doi:10.28982/josam.813042

Cited by 1 publication

(1 citation statement)

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“…The recurrence rate of choledocholithiasis in elderly patients (>65 years) may be as high as 30% [10] . The specific mechanism is not clear, but Akaydin et al [11] suggested that secondary risk factors such as common bile duct dilation and especially PAD, which cause retrograde infection in the papilla, increase the risk of CBDS; this risk is higher in the papillae located within the diverticula. PAD is rare in patients under 40 years of age, and its incidence increases with age.…”

Section: Discussionmentioning

confidence: 99%

Identification of risk factors involved in recurrence after common bile duct stone removal with ERCP

Akay

Sari²

2022

Medicine

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Recurrent stone detection is common after endoscopic treatment of common bile duct stones (CBDS). This study aimed to identify the risk factors for recurrence of CBDS.We retrospectively evaluated 14 patients who underwent endoscopic treatment for CBDS. Risk factors for single and multiple recurrent CBDSs were evaluated using logistic regression analysis.Endoscopic and needle-knife precut sphincterotomy was performed in 506 and 112 patients, respectively. There was 1 recurrence in 85 patients (13.8%), 2 recurrences in 23 patients (3.7%), and 3 recurrences in 9 patients (1.5%). According to the multivariate analyses, being older than 65 years (odds ratio [OR] 1.084, P = .000), concomitant heart disease (OR 2.528, P = .002), concomitant lung disease (OR 1.766, P = .035), a large common bile duct diameter (OR 1.347, P = .000), presence of cholelithiasis (OR 1.752, P = .018), stent (OR 1.794, P = .023), or T-tube placement in the common bile duct (OR 47.385, P = .000), and prolongation of the procedure (OR 1.037, P = .000) increased the risk of recurrence, while having undergone cholecystectomy due to gallstones (OR 1.645, P = .042). The mean stone diameter (P = .059), nitroglycerin use (P = .129), and periampullary diverticulum (P = .891) did not increase the risk of recurrent CBDS.The probability of multiple recurrences after the first recurrence of CBDS increased with age >65 years, concomitant heart/lung diseases, stent/T-tube placement in the common bile duct, a wide common bile duct (≥10 mm), and cholelithiasis.Abbreviations: CBDS = common bile duct stones, CI = confidence interval, CNS = central nervous system, EPBD = endoscopic papillary balloon dilatation, EST = endoscopic sphincterotomy, GBS = gall bladder with stones, OR = odds ratio, PAD = periampullary diverticulum.

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Section: Discussionmentioning

confidence: 99%