Follow-up studies of surgical treatment for choledocholithiasis.

Sato, Toshio; Suzuki, Noriyoshi; Takahashi, Wataru; Uematsu, I

doi:10.1620/tjem.135.1

Cited by 2 publications

(2 citation statements)

References 8 publications

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“…Earlier studies have shown that most recurrences occurred within the first 2 years after the first ERCP 2 3 . Other long-term follow-up studies performed also found that the peak time of recurrence is 2 to 3 years after the first attack 4 5 . Therefore, we believe that we have allowed sufficient follow-up time.…”

Section: Discussionmentioning

confidence: 78%

“…The choice of therapy has to be decided based on a patient’s condition, such as fitness for general anesthesia, tolerance for hepatectomy, previous treatment failure, multiple previous operations, and local anatomic factors 12 . Surgery may only be suitable for a limited number of patients who are younger and can tolerate a procedure, or who have multiple recurrence, multiple stones, or dilatation of duct or presence of stricture 4 5 13 .…”

Section: Discussionmentioning

confidence: 99%

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Correlation of CBD/CHD angulation with recurrent cholangitis in patients treated with ERCP

et al. 2016

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Background and study aims: Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (EST) for bile duct stone extraction has a major role in the treatment of cholangitis. It is well known that certain risk factors predispose to recurrence of such stones. The aims of this study were to evaluate the correlation between angulation of the common bile duct (CBD), right hepatic duct (RHD), and left hepatic duct (LHD) with recurrent cholangitic attacks and to elucidate other risk factors that may be associated with these attacks. Patients and Methods: This is retrospective study included 62 patients who had undergone therapeutic endoscopic retrograde cholangiopancreatography (ERCP) for bile duct stones. Their medical records were followed until May 1, 2009. The RHD, LHD, and CBD angulation and CBD diameter were measured on cholangiography prior to any endoscopic procedures. Results: Among these 62 patients, 6 (9.7 %) had recurrence of cholangitis. Both angles of the RHD and the CBD were significantly smaller in the group with recurrence (P = 0.001, P = 0.004). A CBD angle ≤ 130o and RHD angle ≤ 125o were found to be significantly associated with an increased risk of recurrence (RR = 10.526, P = 0.033; RR = 24.97, P = 0.008) in multivariate analysis. Cholecystectomy was not a protective factor against recurrence of cholangitis (P = 0.615). Conclusions: Angulation of the CBD (≤ 130°) and RHD (≤ 125°) on ERCP are independent risk factors for recurrent cholangitis. Further prospective studies using these data may be warranted for a more accurate estimation and verification of the risk factors predisposing to recurrent cholangitis.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Correlation of CBD/CHD angulation with recurrent cholangitis in patients treated with ERCP

et al. 2016

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Surgical audit of patients undergoing common bile duct exploration for stone

McEntee

Mulvin

Peel

1989

British Journal of Surgery

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One hundred and sixty-four patients operated on for calculus disease of the common bile duct during the period 1977-85 were followed in a special clinic; the attendance for follow-up at 1, 3, 5 and 7 years was 90, 74, 60 and 54 per cent respectively. Eleven patients died during the study period (6.7 per cent), none of the deaths being attributable to biliary tract disease. The overall incidence of retained calculus was 2.4 per cent (four patients), but no cases of retained calculi were recorded in the last 4 years of the study; in this period, with the advent of choledochoscopy and fluoroscopic cholangiography, the incidence of the supraduodenal compared with the transduodenal approach to the common bile duct increased significantly (P less than 0.001). Twenty-two of 56 patients (39 per cent) followed up for 5 years remained or became symptomatic after surgery, the majority of whom had underlying conditions unrelated to disease of the biliary or pancreatic tree. This specific follow-up clinic has been of value in the long-term audit of patients undergoing bile duct surgery for choledocholithiasis and it has verified that a change of policy from transduodenal to supraduodenal choledochotomy with preservation of the sphincter, and use of the choledochoscope and fluorocholangiography, produce better results.

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Follow-up studies of surgical treatment for choledocholithiasis.

Cited by 2 publications

References 8 publications

Correlation of CBD/CHD angulation with recurrent cholangitis in patients treated with ERCP

Correlation of CBD/CHD angulation with recurrent cholangitis in patients treated with ERCP

Surgical audit of patients undergoing common bile duct exploration for stone

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