Does the bile duct angulation affect recurrence of choledocholithiasis?
OBJECTIVE
To investigate whether bile duct angulation and T-tube choledochostomy influence the recurrence of choledocholithiasis.


METHODS
We conducted a retrospective study inclu-ding 259 patients who underwent endoscopic sphincterotomy and cholecystectomy for choledocholithiasis between 2000 and 2007. The imaginary line was drawn along the center of the bile duct and each internal angle was measured at the two angulation sites of the bile duct respectively. The values of both angles were added together. We then tested our hypothesis by examining whether T-tube choledochostomy was performed and stone recurrence occurred by reviewing each subject's medical records.


RESULTS
The overall recurrence rate was 9.3% (24 of 259 patients). The mean value of sums of angles in the recurrence group was 268.3° ± 29.6°, while that in the non-recurrence group was 314.8° ± 19.9° (P < 0.05). Recurrence rate of the T-tube group was 15.9% (17 of 107), while that of the non T-tube group was 4.6% (7 of 152) (P < 0.05). Mean value of sums of angles after T-tube drainage was 262.5° ± 24.6° and that before T-tube drainage was 298.0° ± 23.9° in 22 patients (P < 0.05).


CONCLUSIONS
The bile duct angulation and T-tube choledochostomy may be risk factors of recurrence of bile duct stones.
Division of Gastroenterology, Department of Internal Medicine, Inha University School of Medicine, Incheon 400-711, South Korea.
Dong Beom
DB
Seo
Byoung Wook
BW
Bang
Seok
S
Jeong
Don Haeng
DH
Lee
Shin Goo
SG
Park
Yong Sun
YS
Jeon
Jung Il
JI
Lee
Jin-Woo
JW
Lee
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001652:Bile Ducts / Q000033:anatomy & histology* / Q000601:surgery*; D042883:Choledocholithiasis / Q000517:prevention & control* / Q000601:surgery*; D002768:Choledochostomy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D055815:Young Adult