Does endoscopic sphincterotomy reduce the recurrence rate of cholangitis in patients with cholangitis and suspected of a common bile duct stone not detected by ERCP?
BACKGROUND
It has not been established whether endoscopic sphincterotomy (ES) prevents subsequent cholangitis in patients with cholangitis and with a common bile duct (CBD) stone not documented by ERCP.


OBJECTIVE
The aim of this study was to investigate the role of ES on the recurrence of cholangitis in patients with a high probability of having a CBD stone, not demonstrated by ERCP.


METHODS
A total of 117 patients who were diagnosed as having cholangitis and a high probability of a CBD stone, not detected by ERCP, were retrospectively reviewed. Cumulative recurrence rates of cholangitis were compared for treatments with and without ES.


METHODS
Multicenter, retrospective study.


METHODS
ES.


METHODS
Cumulative recurrence of cholangitis after ERCP.


RESULTS
Eighty-three patients underwent ES (ES group) and 34 patients did not (non-ES group). No statistically significant differences between the 2 groups were evident in terms of demographic factors or laboratory findings. The mean (standard deviation) follow-up was 22.1 +/- 17.2 months (range 3-66 months) in the ES group and 23.3 +/- 14.9 months (range 6-84 months) in the non-ES group (P = .72). The cumulative rates of cholangitis were 6.3% (4.8% vs 9.9%) at 1 year, 15.6% (9.2% vs 29.3%) at 3 years, and 19.5% (9.2% vs 52.9%) at 5 years for ES vs non-ES groups, respectively (P = .04). By multivariate analysis, ES reduced cholangitis recurrence, with a hazard ratio of 0.305 (95% CI 0.095-0.975, P = .045).


CONCLUSIONS
Retrospective study.


CONCLUSIONS
ES reduced further episodes of cholangitis in patients with an episode of cholangitis and a high probability of choledocholithiasis, despite the lack of a CBD stone seen on ERCP.
Lee
Sang Hyub
SH
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
Hwang
Jin-Hyeok
JH
Yang
Ki Young
KY
Lee
Kwang Hyuck
KH
Park
Young Soo
YS
Park
Joo Kyung
JK
Woo
Sang Myung
SM
Yoo
Ji Won
JW
Ryu
Ji Kon
JK
Kim
Yong-Tae
YT
Yoon
Yong Bum
YB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002761:Cholangitis / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D042882:Gallstones / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D055502:Secondary Prevention; D016717:Sphincterotomy, Endoscopic; D016896:Treatment Outcome