title: Ursodeoxycholic acid after bile duct stone removal and risk factors for recurrence: a randomized trial.
abstract: BACKGROUND
  Currently, no established pharmacologic treatment exists for the prevention of recurrent common bile duct (CBD) stones.
  
  
  METHODS
  Here, we present a multi-center randomized trial that compared the CBD recurrence rate after bile duct stone removal between patients given ursodeoxycholic acid (UDCA) and the untreated group. A total of 36 patients were randomly assigned to either the UDCA (n = 15) or the untreated group (n = 21). The primary end-point was the recurrence rate of CBD stones.
  
  
  RESULTS
  The recurrence rate of CBD stones was 6.6% in the UDCA group and 18.6% in the untreated group (P = 0.171). A multivariate analysis found that not receiving UDCA was an independent risk factor for stone recurrence. The recurrence rates of CBD stones did not differ by sex, past history of cholecystectomy, or the presence of gallstones.
  
  
  CONCLUSIONS
  Our findings indicate that UDCA may be a novel treatment strategy to prevent the recurrence of CBD stones. However, further evaluation of UDCA in a larger number of subjects will be required to confirm the applicability of these results.
authors.affiliation: Department of General Internal Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Yamamoto
authors.affiliation: Department of General Internal Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. stazuma@hiroshima-u.ac.jp.
authors.forename: Susumu
authors.initials: S
authors.lastname: Tazuma
authors.affiliation: Department of General Internal Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Keishi
authors.initials: K
authors.lastname: Kanno
authors.affiliation: Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Igarashi
authors.affiliation: Department of Internal Medicine, Banbuntane Houtokukai Hospital, Fujita Health University School of Medicine, Nagoya, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Inui
authors.affiliation: Department of Community-Based Medical Educations, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Ohara
authors.affiliation: Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Tsuyuguchi
authors.affiliation: Saitama Medical University International Medical Center, Saitama, Japan.
authors.forename: Shomei
authors.initials: S
authors.lastname: Ryozawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy; D005260:Female; D042882:Gallstones / Q000517:prevention & control* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012008:Recurrence; D012307:Risk Factors; D014580:Ursodeoxycholic Acid
chemical_list: D014580:Ursodeoxycholic Acid
keywords: Common bile duct stones; Randomized controlled trial; Recurrence; Ursodeoxycholic acid