Risk factors for recurrent symptomatic pigmented biliary stones after percutaneous transhepatic biliary extraction.
OBJECTIVE
To evaluate risk factors for the recurrence of biliary stones after a percutaneous transhepatic biliary stone extraction.


METHODS
The procedures were performed on 339 patients between July 2004 and December 2008 (54 months). Medical records and images were retrospectively reviewed for 135 patients (mean age, 66.4 years; 83 men and 52 women) who had undergone follow-up for a mean of 13.2 months (range, 3-37 months). To evaluate risk factors for the recurrence of biliary stones, variables were evaluated with univariate and multivariate analyses. Variables included sex, age, stone location, number of stones, stone size, presence of a peripapillary diverticulum, application of antegrade sphincteroplasty, presence of a biliary stricture, largest biliary diameter before the procedure, and gallbladder status.


RESULTS
Thirty-three of the 135 patients (24%) had recurrent symptomatic biliary stones and underwent an additional extraction. The mean time to recurrence was 17.2 months +/- 8.7. Univariate analysis of risk factors for recurrence of biliary stones demonstrated that location, number of stones, stone size, application of antegrade sphincteroplasty, presence of a biliary stricture, and biliary diameter were significant factors (P < .05). With use of multivariate analysis, the number of stones (> or =6; relative risk, 64.8; 95% confidence interval: 5.8, 717.6) and stone size (> or =14 mm; relative risk, 3.8; 95% confidence interval: 1.138, 13.231) were determined to be significant risk factors.


CONCLUSIONS
The independent risk factors for recurrence of symptomatic biliary stones after percutaneous transhepatic biliary stone extraction were a stone size of at least 14 mm and the presence of at least six stones.
Department of Radiology, Dong-A University Hospital, Dongdaesin-dong 3 ga, Seo-Gu, Busan, South Korea.
Dong Won
DW
Kim
Sang Yun
SY
Lee
Jin-Han
JH
Cho
Myong Jin
MJ
Kang
Myung Hwan
MH
Noh
Byeong-Ho
BH
Park
D000368:Aged; D005260:Female; D042882:Gallstones / Q000453:epidemiology* / Q000517:prevention & control / Q000601:surgery*; D006801:Humans; D008297:Male; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention; D016896:Treatment Outcome