Long-term results (7 to 10 years) of endoscopic papillotomy for choledocholithiasis. Multivariate analysis of prognostic factors for the recurrence of biliary symptoms

Pereira-Lima, Júlio Carlos; Jakobs, Ralf; Winter, Udo H.; Benz, C.; Martin, Wolf R.; Adamek, Henning E.; Riemann, J F

doi:10.1016/s0016-5107(98)70085-9

Cited by 163 publications

(142 citation statements)

References 34 publications

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“…25 26 In the univariate analysis, a bile duct greater than 10 mm in diameter and bile duct stones greater than 10 mm in diameter tended to increase the recurrence rate. This result is similar to that reported by Pereira-Lima and colleagues, 7 but our interpretation differs from theirs. A stone greater than 10 mm existed in the large bile duct and was usually treated with lithotripsy.…”

Section: -10supporting

confidence: 88%

Risk factors for recurrent bile duct stones after endoscopic papillotomy

Ando

Tsuyuguchi²,

Okugawa³

et al. 2003

Gut

137

151

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Background:The long term outcome of endoscopic papillotomy (EPT) is not well known. The aims of this study were to clarify the clinical course of post-EPT patients and to detect predictors for bile duct stone recurrence. Methods: A total of 1042 consecutive patients who underwent EPT for bile duct stones from December 1975 to September 1998 were prospectively followed up. Patients were divided into four groups according to gall bladder (GB) status: "acalculous GB" group, "calculous GB" group, "cholecystectomy" group, and "prior cholecystectomy" group. Reliable follow up information was obtained for 983 (94.3%) of the 1042 patients. The following factors were considered in the evaluation of predisposing risk factors for recurrence of bile duct stones: age, sex, gall bladder status, periampullary diverticulum, number of bile duct stones, diameter of bile duct stones, diameter of bile duct, lithotripsy, precutting, pneumobilia, and early complications. Results: Recurrence occurred in 111 patients. The "acalculous GB" group was less prone to recurrence than the "prior cholecystectomy" group and the "calculous GB" group. The relative risks (RR) for the latter two compared with the former group were 2.26 (95% confidence interval (CI) 1.24-4.14; p=0.0078) and 2.16 (95% CI 1.21-3.87; p=0.0093), respectively. Other prognostic factors were lithotripsy (RR 2.37; 95% CI 1.47-3.81; p=0.0004) and pneumobilia (RR 1.57; 95% CI 1.01-2.43; p=0.044). Conclusions: Gall bladder status, lithotripsy, and pneumobilia were significantly related to bile duct stone recurrence after EPT.

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Section: -10supporting

confidence: 88%

Risk factors for recurrent bile duct stones after endoscopic papillotomy

Ando

Tsuyuguchi²,

Okugawa³

et al. 2003

Gut

137

151

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“…Unfortunately, 4% to 24% of patients have recurrent CBD stones after the initial extraction of CBD stones (1)(2)(3)(4). Some patients even have multiple recurrences.…”

Section: Introductionmentioning

confidence: 99%

Size of recurrent symptomatic common bile duct stones and factors related to recurrence

Chang

Kim²,

Kim³

et al. 2014

Turk J Gastroenterol

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Background/Aims: Some common bile duct (CBD) stones recur after endoscopic stone extraction. Little information is available on the size and recurrence interval of recurrent symptomatic CBD stones or on ways to prevent recurrence. Materials and Methods: Between January 2007 and December 2011, consecutive 481 patients undergoing endoscopic extraction of CBD stones at a single institute were enrolled. We selected 34 patients with recurrent symptomatic CBD stones and 63 patients who were followed up more than five years without recurrence. Results: The sizes of the CBD stones increased during the recurrences: 10.1±5.2 mm, 13.5±7.3 mm, and 16.8±7.8 mm at the initial presentation, the first recurrence, and the second recurrence, respectively (p=0.016). Among CBD stone recurrences, 50% occurred within 2.3 years, and 80% occurred within 5.3 years. The recurrence group had a smaller proportion of patients under 50 years of age, larger CBD diameters, less histories of more than 10 mm endoscopic papillary large-balloon dilation (EPLBD), and more type I periampullary diverticula, compared with the non-recurrence group (p<0.05). Multivariate analysis revealed that EPLBD more than 10 mm and smaller CBD diameter were independently related to less recurrence of CBD stones (p=0.001 and 0.012, respectively). Conclusion: The sizes of CBD stones increased during recurrences. EPLBD more than 10 mm and smaller CBD diameter were related to less recurrence of CBD stones.

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“…The high success rate and safety of this modality have been well established by a number of studies [1][2][3][4][5] . Because gallstones may pass from the gallbladder (GB) into the CBD, calculous GB is considered to be one of the risk factors for the recurrence of bile duct stones after sphincterotomy [4,6] . Some studies have compared the results of the wait-andsee policy and prophylactic cholecystectomy to prevent biliary complications but arrived at contradictory results [7][8][9] .…”

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confidence: 99%

Risk factors of acute cholecystitis after endoscopic common bile duct stone removal

Ryu¹,

Park

Yoon³

et al. 2006

WJG

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have a higher risk of acute cholecystitis and are possible candidates for prophylactic cholecystectomy. INTRODUCTIONEndoscopic sphincterotomy is the treatment of choice for patients with common bile duct (CBD) stones. The high success rate and safety of this modality have been well established by a number of studies [1][2][3][4][5] . Because gallstones may pass from the gallbladder (GB) into the CBD, calculous GB is considered to be one of the risk factors for the recurrence of bile duct stones after sphincterotomy [4,6] . Some studies have compared the results of the wait-andsee policy and prophylactic cholecystectomy to prevent biliary complications but arrived at contradictory results [7][8][9] . Thus, it still remains controversial as to whether subsequent laparoscopic cholecystectomy is indicated in patients with concurrent GB stones. Most studies have focused on the identification of predictors of CBD stone recurrence, which can be treated again endoscopically without surgery; however, the development of acute cholecystitis is a definite indication of cholecystectomy. So the risk factors of subsequent acute cholecystitis are more important than those of recurrent CBD stones in terms of the decision concerning prophylactic cholecystectomy. However, few studies have identified the risk factors of acute cholecystitis after endoscopic CBD stone removal in patients with GB in situ. The aims of this study were to assess the risks of biliary symptom recurrence and to identify the risk factors of acute cholecystitis in patients with GB in situ who have received endoscopic CBD stone removal. MATERIALS AND METHODS PatientsThe medical records of patients with GB in situ who Abstract AIM: To evaluate the risk factors of acute cholecystitis after endoscopic common bile duct (CBD) stone removal.PO Box 2345, Beijing 100023, China World J Gastroenterol 2006 February 14; 12(6): 956-960 www.wjgnet.com World Journal of Gastroenterology ISSN 1007-9327 wjg@wjgnet.com © 2006 The WJG Press. All rights reserved. RAPID COMMUNICATION METHODS:A total 100 of patients who underwent endoscopic CBD stone removal with gallbladder (GB) in situ without subsequent cholecystectomy from January 2000 to July 2004 were evaluated retrospectively. The following factors were considered while evaluating risk factors for the development of acute cholecystitis: age, gender, serum bilirubin level, GB wall thickening, cystic duct patency, presence of a GB stone, CBD diameter, residual stone, lithotripsy, juxtapapillary diverticulum, presence of liver cirrhosis or diabetes mellitus, a presenting illness of cholangitis or pancreatitis, and procedure-related complications. RESULTS:During a mean 18-mo follow-up, 28 (28%) patients developed biliary symptoms; 17 (17%) acute cholecystitis and 13 (13%) CBD stone recurrence. Of patients with acute cholecystitis, 15 (88.2%) received laparoscopic cholecystectomy and 2 (11.8%) open cholecystectomy. All recurrent CBD stones were successfully removed endoscopically. The mean time elapse to acute cholecystitis was 1...

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Long-term results (7 to 10 years) of endoscopic papillotomy for choledocholithiasis. Multivariate analysis of prognostic factors for the recurrence of biliary symptoms

Cited by 163 publications

References 34 publications

Risk factors for recurrent bile duct stones after endoscopic papillotomy

Risk factors for recurrent bile duct stones after endoscopic papillotomy

Size of recurrent symptomatic common bile duct stones and factors related to recurrence

Risk factors of acute cholecystitis after endoscopic common bile duct stone removal

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