[Risk factors for recurrent bile duct stones after endoscopic clearance of common bile duct stones].
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.
Baek
Yoo Hum
YH
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Seoul, Korea.
Kim
Hong Joo
HJ
Park
Jung Ho
JH
Park
Dong Il
DI
Cho
Yong Kyun
YK
Sohn
Chong Il
CI
Jeon
Woo Kyu
WK
Kim
Byung Ik
BI
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
D014580:Ursodeoxycholic Acid