title: [Risk factors for recurrent bile duct stones after endoscopic clearance of common bile duct stones].
abstract: OBJECTIVE
  We aimed to explore the risk factors contributing to the recurrence of common bile duct (CBD) stones after successful endoscopic stone clearance, focused on the anatomical factors of CBD and presence or absence of ursodeoxycholic acid (UDCA)/RowacholR medication.
  
  
  METHODS
  One hundred fourteen patients who underwent CBD stone(s) extraction by endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy at our institution from August 2004 to January 2007 were included. Univariate and multivariate analyses for the risk factors including the distal CBD angle, length of the distal CBD arm and medication such as ursodeoxycholic acid (UDCA) and/or RowacholR for recurrent CBD stone(s) were performed.
  
  
  RESULTS
  The recurrence of CBD stone(s) was found in 22 (19.3%) patients. On univariate analysis, presence of pneumobilia, presence of type 1 or type 2 periampullary diverticulum, mechanical lithotripsy and multiple sessions of ERCP were significant contributors for the recurrence of CBD stone(s). On multivariate analysis, the presence of type 1 periampullary diverticulum (OR 7.90, 95% CI: 1.56-40.16) and multiple sessions of ERCP (OR 7.56, 95% CI: 2.21-25.87) were significant contributors. Acute distal CBD angulation (<135), shorter distal CBD arm (<36 mm), technical difficulty of CBD stone(s) clearance, and the prescription of UDCA and/or RowacholR were not significantly associated with the recurrence of CBD stone(s).
  
  
  CONCLUSIONS
  The recurrence of CBD stone(s) was more commonly found in the patients group with type 1 periampullary diverticulum and multiple sessions of ERCP. Therefore, patients with these risk factors should be on regular follow up.
authors.affiliation: Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Seoul, Korea.
authors.forename: Yoo Hum
authors.initials: YH
authors.lastname: Baek
authors.forename: Hong Joo
authors.initials: HJ
authors.lastname: Kim
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Park
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Park
authors.forename: Yong Kyun
authors.initials: YK
authors.lastname: Cho
authors.forename: Chong Il
authors.initials: CI
authors.lastname: Sohn
authors.forename: Woo Kyu
authors.initials: WK
authors.lastname: Jeon
authors.forename: Byung Ik
authors.initials: BI
authors.lastname: Kim
mesh_terms: D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003135:Common Bile Duct / Q000000981:diagnostic imaging; D003627:Data Interpretation, Statistical; D005260:Female; D042882:Gallstones / Q000000981:diagnostic imaging / Q000517:prevention & control / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D016717:Sphincterotomy, Endoscopic; D016896:Treatment Outcome; D014580:Ursodeoxycholic Acid / Q000494:pharmacology
chemical_list: D014580:Ursodeoxycholic Acid