title: Risk factors for recurrent cholangitis after initial hepatolithiasis treatment.
abstract: OBJECTIVE
  To elucidate the risk factors that can affect the rate of cholangitis after hepatolithiasis treatment.
  
  
  BACKGROUND
  Hepatolithiasis is prevalent in East Asia and causes long-term complications. Recurrent cholangitis is one of its most serious complications and can lead to biliary stricture, liver cirrhosis, and even cholangiocarcinoma. However, little is known about the risk factors associated with cholangitis.
  
  
  METHODS
  The clinical records of 193 patients with hepatolithiasis who had been newly diagnosed and treated were reviewed. The mean follow-up was 56 months (1-242 months).
  
  
  RESULTS
  Cumulative cholangitis rates were 25.0% at 3 years and 37.0% at 5 years. By multivariate analysis, cholangitis was associated with hepatic resection (Hazard ratio [HR] = 0.28; 95% confidence interval [CI]: 0.12-0.65), residual stones (HR = 1.77; 95% CI: 1.05-2.98), and recurrent stones (HR = 4.02; 95% CI: 1.31-12.36), but not Sphincter of Oddi disruption. Though biliary stricture did not in general affect the cholangitis rate, a stricture located in the common hepatic or common bile duct was associated with a higher rate of cholangitis than a stricture in the intrahepatic duct alone.
  
  
  CONCLUSIONS
  Cholangitis occurs frequently in hepatolithiasis patients with a common hepatic or common bile duct stricture, residual stones, recurrent stones, and in those that are treated by nonhepatic resection.
authors.affiliation: Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jin-Hyeok
authors.initials: JH
authors.lastname: Hwang
authors.forename: Yong Bum
authors.initials: YB
authors.lastname: Yoon
authors.forename: Yong-Tae
authors.initials: YT
authors.lastname: Kim
authors.forename: Jae Hee
authors.initials: JH
authors.lastname: Cheon
authors.forename: Ji Bong
authors.initials: JB
authors.lastname: Jeong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001652:Bile Ducts / Q000473:pathology / Q000601:surgery; D002761:Cholangitis / Q000209:etiology / Q000601:surgery*; D042883:Choledocholithiasis / Q000150:complications / Q000601:surgery; D002768:Choledochostomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome