Endoscopic Management of Recurrent Primary Bile Duct Stones

Kohn, Geoffrey P.; Hassen, A. Sayed; Banting, Simon; Mackay, Sean; Cade, Richard

doi:10.1111/j.1445-2197.2008.04577.x

Cited by 5 publications

(8 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[9][10][11][12][14][15][16][17][18][19][20] However, the recurrence rate of CBD stones has been in the range of 4-24%. [1][2][3][4][5][6] Furthermore, most recurrences occur within the first 2 or 3 years 6,[9][10][11]13 after stone removal and 39-54% of the patients with recurrent stones are asymptomatic.…”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13]21 Finally, computed tomography and magnetic resonance cholangiopancreatography are less sensitive to detect small stones in a dilated bile duct and ultimately they are dependent on ERCP for stone removal. 5,10,13,22,23 In addition, follow-up ERCP has been proven to be safer 11,13,14,24,25 than the initial ERCP. Therefore, the ideal follow-up strategy after CBD stone removal is to follow up the high risk patients with ERCP.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Efficacy of Early Scheduled Follow-Up Endoscopic Retrograde Cholangiopancreatography after Common Bile Duct Stone Removal

Kim

Lee²,

Jung³

et al. 2011

Gut Liver

View full text Add to dashboard Cite

Background/Aims: To investigate the effi cacy of early scheduled follow-up endoscopic retrograde cholangiopancreatography (ERCP) after common bile duct (CBD) stone removal. Methods: Patients who underwent endoscopic CBD stone removal and who had at least one risk factor for stone recurrence were enrolled. Six months after complete clearance of the CBD, patients underwent follow-up ERCP at an ambulatory care center, irrespective of symptoms. Results: The incidence of symptoms and cholangitis at follow-up ERCP was signifi cantly lower in Group A (ERCP at 6 months after stone removal) than that in Group B (ERCP at >6 months) (14.3% vs 71.4%, p=0.00; 9.5% vs 33.3%, p=0.02, respectively). However, the recurrence rates of CBD stones were not different between Groups A and B (33.3% vs 47.6%). When comparing the subgroups, Group AR (stone recurrence in Group A) displayed signifi cantly fewer symptoms and lesser cholangitis and spent fewer days in the hospital than did Group BR (stone recurrence in Group B) (21.4% vs 70%, p=0.02; 14.3% vs 60%, p=0.02; 2.43±1.87 vs 6.10±3.35, p=0.00, respectively). Conclusions: Our data suggest that, irrespective of symptoms, early scheduled follow-up ERCP for patients who are at a high risk of recurrence is effective and safe. (Gut Liver 2011;5:65-69) Key Words: Risk factor; Recurrence; Common bile duct stone; Endoscopic retrograde cholangiopancreatography; Cholangitis INTRODUCTIONThe recurrence rates of common bile duct (CBD) stones after endoscopic stone removal have been reported to range from 4% to 24%. [1][2][3][4][5][6] Many risk factors for the recurrence of CBD stones such as CBD dilatation, acute CBD angulation, periampullary diverticulum (PAD), a history of cholecystectomy and the number of CBD stones have been reported. [5][6][7][8][9][10][11][12] The early detection and treatment of recurrent CBD stones may help to avoid more serious complication such as acute suppurative cholangitis. Several studies [8][9][10]13 have reported that regular clinical follow-up of patients after CBD stones removal is beneficial and it reduces the morbidity related to stone recurrence. However, early detection of CBD stone is not easy even after physical examinations, biochemical tests and ultrasonography. Furthermore, the majority of patients who are without risk factors for recurrence will have no further recurrence after stone removal. Therefore, if followup evaluations are restricted to the patients who are at a high risk for recurrence, then the cost of subsequent examinations may be reduced. In addition, if early scheduled follow-up endoscopic retrograde cholangiopancreatography (ERCP) is more accurate to detect stones and it is safer and feasible for removing the recurrent CBD stone as compared with regular clinical follow-up, then it should be the modality of choice to follow-up the patients who are at a high risk for recurrence. So, we conducted a prospective study on patients who are at a high risk for recurrence to evaluate the efficacy of early scheduled follow-up ERCP after CBD ...

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Efficacy of Early Scheduled Follow-Up Endoscopic Retrograde Cholangiopancreatography after Common Bile Duct Stone Removal

Kim

Lee²,

Jung³

et al. 2011

Gut Liver

View full text Add to dashboard Cite

show abstract

“…[ 5 – 7 ] At present, there are different reports on the recurrence rate of CBDS after ERCP, ranging from 4% to 24%. [ 3 , 5 , 7 , 8 ] In addition, there are different research results on the related factors of CBDS recurrence. [ 3 , 5 , 7 , 8 ] In general, the cause of recurrence of CBDS after ERCP is caused by many factors.…”

Section: Introductionmentioning

confidence: 99%

“…[ 3 , 5 , 7 , 8 ] In addition, there are different research results on the related factors of CBDS recurrence. [ 3 , 5 , 7 , 8 ] In general, the cause of recurrence of CBDS after ERCP is caused by many factors. [ 3 , 5 , 7 , 8 ] How to prevent and reduce the recurrence of CBDS after ERCP has become the focus of hepatobiliary surgeons.…”

Section: Introductionmentioning

confidence: 99%

“…[ 3 , 5 , 7 , 8 ] In general, the cause of recurrence of CBDS after ERCP is caused by many factors. [ 3 , 5 , 7 , 8 ] How to prevent and reduce the recurrence of CBDS after ERCP has become the focus of hepatobiliary surgeons. In this study, the clinical data of ERCP patients in our hospital from March 2012 to May 2016 were collected and analyzed to explore the recurrence rate and related risk factors of ERCP in patients with CBDS, so as to provide reference for reducing the recurrence rate of CBDS after ERCP.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Risk factors of stone recurrence after endoscopic retrograde cholangiopancreatography for common bile duct stones

2020

View full text Add to dashboard Cite

To explore the risk factors related to the recurrence of common bile duct stones (CBDS) after endoscopic retrograde cholangiopancreatography (ERCP), so as to provide reference for reducing the recurrence of CBDS after ERCP. The clinical data of 385 patients with CBDS treated by ERCP from March 2012 to May 2016 were collected. According to the diagnostic criteria of recurrence of CBDS, the patients were divided into recurrence group and control group. The general information of the patients, personal history, past history, and surgical-related information were collected. Univariate analysis and multivariate logistic regression analysis were performed on the collected data to identify risk factors for recurrence of CBDS after ERCP. A total of 262 patients were included in the study, of which 51 had recurrence of CBDS, with a recurrence rate of 19.46%. Multivariate Logistic analysis (Table 2 ) showed greasy diet ( P = .436), history of cholecystectomy ( P = .639) and gallstone size ( P = .809) were not independent risk factor for recurrence of stones after ERCP in CBDS. But age ≥65 ( P = .013), history of common bile duct incision ( P = .001), periampullary diverticulum ( P = .001), common bile duct diameter ≥1.5 cm ( P = .024), ERCP ≥2 ( P = .003), the number of stones ≥2 ( P = .015), the common bile duct angle ≤120° ( P = .002) and the placement of bile duct stent ( P = .004) are important independent risk factor for recurrence of stones after ERCP in CBDS. This study confirmed that ag ≥65, history of choledochotomy, periampullary diverticulum, diameter of common bile duct (≥15 mm), multiple ERCP, the number of stones ≥2, stent placement and angle of common bile duct < 120° were independent risk factors for recurrence of CBDS after ERCP.

show abstract

Case on Complicated Retained Stones in the Common Bile Duct After Multiple Sphincterotomies by ERCP

Diepenhorst

2013

Case Studies of Postoperative Complications After Digestive Surgery

View full text Add to dashboard Cite

Endoscopic Management of Recurrent Primary Bile Duct Stones

Abstract: Repeated endoscopic stone extraction by endoscopic retrograde cholangiopancreatography when required is a safe policy. However, this technique will only provide temporary relief from primary duct stones and repeated endoscopic treatment, again safe, will be required.

Cited by 5 publications

References 23 publications

The Efficacy of Early Scheduled Follow-Up Endoscopic Retrograde Cholangiopancreatography after Common Bile Duct Stone Removal

The Efficacy of Early Scheduled Follow-Up Endoscopic Retrograde Cholangiopancreatography after Common Bile Duct Stone Removal

Risk factors of stone recurrence after endoscopic retrograde cholangiopancreatography for common bile duct stones

Case on Complicated Retained Stones in the Common Bile Duct After Multiple Sphincterotomies by ERCP

Contact Info

Product

Resources

About