Common bile duct (CBD) stone is a relatively common but potentially life-threatening disease. Endoscopic sphincterotomy (EST) has been performed as standard therapy for CBD stones, but the rate of recurrence of CBD stones is high. Risk factors have been poorly defined, and no effective means for the prevention of the recurrence of CBD stones have been established so far. We aimed to identify significant risk factors for the recurrence of bile duct stones. This study included 477 patients (231 women; mean age, 80.5 years) who underwent EST and cleared CBD stones on cholangiography. A retrospective analysis was performed for the consecutively collected data. During the follow-up period of 6-75 months, the recurrence of CBD stones was observed in 99 patients (20.8%). The median time to the recurrence was 19.0 months (range 4-72 months). Multivariate analysis identified the need for mechanical lithotripsy, which was used for stone fragmentation, as a risk factor. Mechanical lithotripsy caused cholangiography-negative small residua. Notably, saline solution irrigation of the bile duct reduced the recurrence of CBD stones. These results demonstrate that subsequent biliary irrigation after stone removal may prevent the recurrence of CBD stones by clearing small residual fragments.

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[Background] Ovarian teratomas are the most common ovarian tumors in children. Fertility-sparing surgery (FSS) is often recommended owing to its advantage of fertility preservation. We examined the validity of FSS in pediatric patients with ovarian teratomas. [Procedure] We retrospectively reviewed the medical records of patients who underwent initial surgery for ovarian teratomas in our department between 1972–2021. Patients were divided into two groups: oophorectomy (OVX) group and FSS group. Clinical characteristics, perioperative characteristics, and outcomes were compared between the groups. [Results] Forty-six patients underwent initial surgery (OVX: 25 patients; FSS: 21 patients). There were no differences between the groups in terms of age, pathological diagnosis, affected side, ovarian torsion, postoperative complications, recurrence rate, or length of postoperative follow-up. Regarding pathological diagnosis, immature teratomas were found only in the OVX group (p = 0.0161). The tumor size was larger in the OVX group (p = 0.0104). Regarding perioperative findings, operation time was longer in the FSS group (p = 0.0071) and bleeding volume was higher in the OVX group (p = 0.0070). The number of days until the start of oral intake and the length of hospital stay postoperatively were shorter in the FSS group (p = 0.0002 and p < 0.0001, respectively). [Conclusion] We demonstrated the advantages of FSS, including its minimally invasive approach and comparable outcomes in terms of tumor recurrence; the operation time was longer. Since both FSS and OVX are associated with a risk of tumor recurrence, long-term follow-up in anticipation of adult transition is necessary.