title: Preventive saline irrigation of the bile duct after the endoscopic removal of common bile duct stones.
abstract: BACKGROUND
  Small stone fragments after an endoscopic stone extraction for choledocholithiasis may act as the nidus for recurrent choledocholithiasis. Therefore, efforts to eliminate the nidus might reduce the recurrence of choledocholithiasis and cholangitis related to choledocholithiasis.
  
  
  OBJECTIVE
  The purpose of this study was to determine whether an additional preventive saline irrigation of the bile duct after the endoscopic removal of common bile duct stones would decrease residual stones and the recurrence of cholangitis.
  
  
  METHODS
  A retrospective analysis was performed for the consecutively collected data about the patients who underwent the complete endoscopic treatment for common bile duct stone.
  
  
  RESULTS
  Among 99 patients, 45 patients underwent saline irrigation. Residual stones were detected in 18 patients (18.2 %). The incidences of residual stones were 8.9 % (4 of 45 patients) in the irrigation group and 25.9 % (14 of 54 patients) in the non-irrigation group (P = 0.037). In multivariate analysis, preventive saline irrigation was found to be the only significant factor for the decrease of residual stones (HR = 0.258, P = 0.039). When analyzing the occurrence of recurrent cholangitis and the procedure related to complications, there were no significant differences according to the performance of preventive saline irrigation of the bile duct.
  
  
  CONCLUSIONS
  Preventive saline irrigation could reduce the residual common bile duct stones without complications.
authors.affiliation: Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Sang Eon
authors.initials: SE
authors.lastname: Jang
authors.forename: Dong-Won
authors.initials: DW
authors.lastname: Ahn
authors.forename: Sang Hyub
authors.initials: SH
authors.lastname: Lee
authors.forename: Ban Seok
authors.initials: BS
authors.lastname: Lee
authors.forename: Ji Bong
authors.initials: JB
authors.lastname: Jeong
authors.forename: Jin-Hyeok
authors.initials: JH
authors.lastname: Hwang
authors.forename: Ji Kon
authors.initials: JK
authors.lastname: Ryu
authors.forename: Yong-Tae
authors.initials: YT
authors.lastname: Kim
authors.forename: Kyoung Ho
authors.initials: KH
authors.lastname: Lee
authors.forename: Young Hoon
authors.initials: YH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003135:Common Bile Duct / Q000601:surgery*; D016145:Endoscopy, Digestive System; D005260:Female; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012965:Sodium Chloride / Q000627:therapeutic use*; D007507:Therapeutic Irrigation / Q000379:methods*
chemical_list: D012965:Sodium Chloride
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