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

Abstract

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.

Reinterventions following laparoscopic cholecystectomy and bile duct exploration. A review of prospective data from 5740 patients

“…Gupta et al [ 24 ] also found that ERCP involved more reinterventions than one-stage treatment of bile duct stones. Laparoscopic CBDE also reduces the incidence of recurrent stones, thus avoiding inevitable future reinterventions [ 25 , 26 ].…”

Patients with Primary and Secondary Bile Duct Stones Harbor Distinct Biliary Microbial Composition and Metabolic Potential

“…To date, endoscopic retrograde cholangiopancreatography (ERCP) remains the effective and minimally invasive treatment option for bile duct stone ( Cianci and Restini, 2021 ). However, the relapse rate of bile duct stone is still high, up to 4-24% within 3-5 years, which can lead to patients’ suffering, increased medical expenditure, and risk of cholangiocarcinoma ( Lujian et al., 2020 ).…”

Diabetes mellitus is associated with a higher rate of acute cholangitis among patients with common bile duct stones

“…Approximately 1.5% of the general population suffers from CBD stone, and the prevalence increases with age. [ 8 ] In fact, CBD stone spectrum of clinical presentations ranges from mild disease including biliary colic and abnormal liver enzymes to the more severe and life-threatening diseases, including pancreatitis, cholangitis, and sepsis, which can deteriorate and lead to death. In our study, and for the first time, we identified that DM significantly correlated with acute cholangitis among patients with CBD stone on univariate and multivariate analysis with OR of 1.93 (95% CI 1.26–2.96).…”