title: Morphologic factors of biliary trees are associated with gallstone-related biliary events.
abstract: OBJECTIVE
  To determine the risk factors for gallstone-related biliary events.
  
  
  METHODS
  This retrospective cohort study evaluated magnetic resonance cholangiopancreatography images from 141 symptomatic and 39 asymptomatic gallstone patients who presented at a single tertiary hospital between January 2005 and December 2012.
  
  
  RESULTS
  Logistic regression analysis showed significant differences between symptomatic and asymptomatic patients with gallstones in relation to the number of gallstones, the angle between the long axis of the gallbladder and the cystic duct, and the cystic duct diameter. Multivariate analysis showed that the number of gallstones (OR = 1.27, 95%CI: 1.03-1.57; P = 0.026), the angle between the long axis of the gallbladder and the cystic duct (OR = 1.02, 95%CI: 1.00-1.03; P = 0.015), and the diameter of the cystic duct (OR = 0.819, 95%CI: 0.69-0.97; P = 0.018) were significantly associated with biliary events. The incidence of biliary events was significantly elevated in patients who had the presence of more than two gallstones, an angle of > 92° between the gallbladder and the cystic duct, and a cystic duct diameter < 6 mm.
  
  
  CONCLUSIONS
  These findings will help guide the treatment of patients with asymptomatic gallstones. Clinicians should closely monitor patients with asymptomatic gallstones who exhibit these characteristics.
authors.affiliation: Jin-Seok Park, Don Haeng Lee, Jun Hyeok Lim, Seok Jeong, Department of Internal Medicine, Digestive Disease Center, Inha University School of Medicine, Incheon 400-711, South Korea.
authors.forename: Jin-Seok
authors.initials: JS
authors.lastname: Park
authors.affiliation: Jin-Seok Park, Don Haeng Lee, Jun Hyeok Lim, Seok Jeong, Department of Internal Medicine, Digestive Disease Center, Inha University School of Medicine, Incheon 400-711, South Korea.
authors.forename: Don Haeng
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Jin-Seok Park, Don Haeng Lee, Jun Hyeok Lim, Seok Jeong, Department of Internal Medicine, Digestive Disease Center, Inha University School of Medicine, Incheon 400-711, South Korea.
authors.forename: Jun Hyeok
authors.initials: JH
authors.lastname: Lim
authors.affiliation: Jin-Seok Park, Don Haeng Lee, Jun Hyeok Lim, Seok Jeong, Department of Internal Medicine, Digestive Disease Center, Inha University School of Medicine, Incheon 400-711, South Korea.
authors.forename: Seok
authors.initials: S
authors.lastname: Jeong
authors.affiliation: Jin-Seok Park, Don Haeng Lee, Jun Hyeok Lim, Seok Jeong, Department of Internal Medicine, Digestive Disease Center, Inha University School of Medicine, Incheon 400-711, South Korea.
authors.forename: Young Sun
authors.initials: YS
authors.lastname: Jeon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058070:Asymptomatic Diseases; D001659:Biliary Tract / Q000473:pathology*; D001660:Biliary Tract Diseases / Q000209:etiology* / Q000473:pathology; D016009:Chi-Square Distribution; D049448:Cholangiopancreatography, Magnetic Resonance; D005260:Female; D042882:Gallstones / Q000150:complications* / Q000473:pathology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D056910:Republic of Korea; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D062606:Tertiary Care Centers
keywords: Cystic duct; Gallbladder; Gallstone disease; Magnetic resonance cholangiopancreatography; Risk factor