Recurrence of common bile duct stones following laparoscopic common bile duct exploration: a multicenter study

Abstract

Background Recurrence of common bile duct stone (CBDS) is not common after laparoscopic common bile duct exploration (LCBDE). This study aimed to investigate the risk factors of recurrence of CBDS after LCBDE. Methods Patients who underwent LCBDE between January 2001 and December 2018 in four teaching hospitals of The Catholic University of Korea were included. The operation, fluoroscopy, and endoscopic retrograde cholangiopancreatography records were investigated retrospectively. The primary outcome of this study was the independent risk factors for recurrence of CBDS. Results A total of 230 patients were included in this study. Thirty‐one patients had recurrence of CBDS. In univariate analysis, CBDS size (>9 mm) (P = 0.003), multiple stones (≥2) (P = 0.031), stone size (≥1.5 cm) (P = 0.041), CBD diameter (≥12 mm) (P = 0.005), CBD dilatation (≥10 mm) (P = 0.02), prior history of laparoscopic cholecystectomy (P = 0.002) were associated with recurrence. After multivariable logistic regression, CBDS size (>9 mm) (OR 4.67, 95% CI 1.35–16.18, P = 0.011), CBD dilatation (≥10 mm) (OR 5.66, 95% CI 1.47–21.82, P = 0.012), and prior history of laparoscopic cholecystectomy (AOR 3. 90, 95% CI 1.34–11.37, P = 0.013) were associated with recurrence. Conclusions Stone size >9 mm, CBD diameter ≥10 mm, and prior history of laparoscopic cholecystectomy were risk factors for recurrence of CBDS after LCBDE.

Differences in Outcome and Comparison of Stress and Immune Status in Patients with Recurrent Common Bile Duct Stones after Biliary Tract Surgery Choosing Three Procedures (ERCP, OCBDE, and LCBDE) for Treatment

“…In comparison to patients treated with surgery on other abdominal organs, a higher percentage of biliary surgery patients need subsequent surgery, which may have a substantial physical and psychological effect on patients and is a significant medical burden [ 8 , 9 ]. Duodenal diverticulum [ 10 ], common bile duct dilatation [ 11 ], and surgical injury to the common bile duct [ 12 ] are all factors that impact recurrent common bile duct stones following biliary surgery. Age, gender, heredity, metabolism, dietary habits, and obesity, according to other research, may all have a role in the recurrence of common bile duct stones following biliary surgery [ 2 , 13 , 14 ].…”

Advances in Risk Factors for Recurrence of Common Bile Duct Stones

“…This function is also lost when the gallbladder is removed. Park et al (65) showed a prior history of cholecystectomy can increase the risk recurrence of choledocholithiasis after LCBDE and reported that prophylactic cholecystectomy was not required to prevent recurrence of choledocholithiasis in Asian populations without stones after ERCP stone removal. YOO et al (96) found that cholesterol stones were a risk factor for the recurrence of choledocholithiasis after cholecystectomy.…”

“…(25,55) However, a large number of follow-up observations showed that the recurrence rate of common bile duct stone after endoscopic treatment was 4%-25%. (60,65) Choledocholithiasis may cause acute suppurative cholangitis, pancreatitis, biliary perforation, etc. The recurrent factors of choledocholithiasis are complex and cannot be explained by a single factor.…”

Comparison of one-stage laparoscopic common bile duct exploration plus cholecystectomy and two-stage endoscopic sphincterotomy plus laparoscopic cholecystectomy for concomitant gallbladder and common bile duct stones in patients over 80 years old

“…In our study, the clearance rates of one-stage LCBDE + LC (91.3%) and two-stage EST + LC (95.6%) were similar to those reported in a previous study. Long-term follow-up studies have reported, that CBD stones recur in approximately 2.1% to 13.5 % of cases after LCBDE and 7.5% to 9.5 % of cases after EST [ 19 – 21 ]. In the present study, recurrence rates of CBD stones after LCBDE or EST were 4.3% and 8.8%, respectively, which are similar to those of previous studies.…”