Risk factors for recurrent bile duct stones after endoscopic papillotomy

Ando, Takeshi; Tsuyuguchi, Toshio; Okugawa, Tadahiro; Saito, M.; Ishihara, Takeshi; Yamaguchi, Taketo; Saisho, Hiromitsu

doi:10.1136/gut.52.1.116

Cited by 140 publications

(191 citation statements)

References 30 publications

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“…Greater incidence of ascending infection and lower CBD stone density may be possible explanations, but this needs to be studied further. [16][17][18]. The present study demonstrated that CBD diameter and EPLBD more than 10 mm were independent factors related to recurrence upon multivariate analysis.…”

Section: Discussionmentioning

confidence: 70%

Size of recurrent symptomatic common bile duct stones and factors related to recurrence

Chang

Kim²,

Kim³

et al. 2014

Turk J Gastroenterol

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Background/Aims: Some common bile duct (CBD) stones recur after endoscopic stone extraction. Little information is available on the size and recurrence interval of recurrent symptomatic CBD stones or on ways to prevent recurrence. Materials and Methods: Between January 2007 and December 2011, consecutive 481 patients undergoing endoscopic extraction of CBD stones at a single institute were enrolled. We selected 34 patients with recurrent symptomatic CBD stones and 63 patients who were followed up more than five years without recurrence. Results: The sizes of the CBD stones increased during the recurrences: 10.1±5.2 mm, 13.5±7.3 mm, and 16.8±7.8 mm at the initial presentation, the first recurrence, and the second recurrence, respectively (p=0.016). Among CBD stone recurrences, 50% occurred within 2.3 years, and 80% occurred within 5.3 years. The recurrence group had a smaller proportion of patients under 50 years of age, larger CBD diameters, less histories of more than 10 mm endoscopic papillary large-balloon dilation (EPLBD), and more type I periampullary diverticula, compared with the non-recurrence group (p<0.05). Multivariate analysis revealed that EPLBD more than 10 mm and smaller CBD diameter were independently related to less recurrence of CBD stones (p=0.001 and 0.012, respectively). Conclusion: The sizes of CBD stones increased during recurrences. EPLBD more than 10 mm and smaller CBD diameter were related to less recurrence of CBD stones.

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Section: Discussionmentioning

confidence: 70%

Size of recurrent symptomatic common bile duct stones and factors related to recurrence

Chang

Kim²,

Kim³

et al. 2014

Turk J Gastroenterol

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“…Interestingly, a dilated CBD was identified as a risk factor of bile duct stone recurrence after endoscopic papillotomy by previous studies [4,6] . However, our results should be interpreted from a different point of view because the pathogenesis of CBD stone recurrence and the development of acute cholecystitis differ.…”

Section: Discussionmentioning

confidence: 85%

“…The high success rate and safety of this modality have been well established by a number of studies [1][2][3][4][5] . Because gallstones may pass from the gallbladder (GB) into the CBD, calculous GB is considered to be one of the risk factors for the recurrence of bile duct stones after sphincterotomy [4,6] . Some studies have compared the results of the wait-andsee policy and prophylactic cholecystectomy to prevent biliary complications but arrived at contradictory results [7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

Risk factors of acute cholecystitis after endoscopic common bile duct stone removal

Ryu¹,

Park

Yoon³

et al. 2006

WJG

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have a higher risk of acute cholecystitis and are possible candidates for prophylactic cholecystectomy. INTRODUCTIONEndoscopic sphincterotomy is the treatment of choice for patients with common bile duct (CBD) stones. The high success rate and safety of this modality have been well established by a number of studies [1][2][3][4][5] . Because gallstones may pass from the gallbladder (GB) into the CBD, calculous GB is considered to be one of the risk factors for the recurrence of bile duct stones after sphincterotomy [4,6] . Some studies have compared the results of the wait-andsee policy and prophylactic cholecystectomy to prevent biliary complications but arrived at contradictory results [7][8][9] . Thus, it still remains controversial as to whether subsequent laparoscopic cholecystectomy is indicated in patients with concurrent GB stones. Most studies have focused on the identification of predictors of CBD stone recurrence, which can be treated again endoscopically without surgery; however, the development of acute cholecystitis is a definite indication of cholecystectomy. So the risk factors of subsequent acute cholecystitis are more important than those of recurrent CBD stones in terms of the decision concerning prophylactic cholecystectomy. However, few studies have identified the risk factors of acute cholecystitis after endoscopic CBD stone removal in patients with GB in situ. The aims of this study were to assess the risks of biliary symptom recurrence and to identify the risk factors of acute cholecystitis in patients with GB in situ who have received endoscopic CBD stone removal. MATERIALS AND METHODS PatientsThe medical records of patients with GB in situ who Abstract AIM: To evaluate the risk factors of acute cholecystitis after endoscopic common bile duct (CBD) stone removal.PO Box 2345, Beijing 100023, China World J Gastroenterol 2006 February 14; 12(6): 956-960 www.wjgnet.com World Journal of Gastroenterology ISSN 1007-9327 wjg@wjgnet.com © 2006 The WJG Press. All rights reserved. RAPID COMMUNICATION METHODS:A total 100 of patients who underwent endoscopic CBD stone removal with gallbladder (GB) in situ without subsequent cholecystectomy from January 2000 to July 2004 were evaluated retrospectively. The following factors were considered while evaluating risk factors for the development of acute cholecystitis: age, gender, serum bilirubin level, GB wall thickening, cystic duct patency, presence of a GB stone, CBD diameter, residual stone, lithotripsy, juxtapapillary diverticulum, presence of liver cirrhosis or diabetes mellitus, a presenting illness of cholangitis or pancreatitis, and procedure-related complications. RESULTS:During a mean 18-mo follow-up, 28 (28%) patients developed biliary symptoms; 17 (17%) acute cholecystitis and 13 (13%) CBD stone recurrence. Of patients with acute cholecystitis, 15 (88.2%) received laparoscopic cholecystectomy and 2 (11.8%) open cholecystectomy. All recurrent CBD stones were successfully removed endoscopically. The mean time elapse to acute cholecystitis was 1...

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“…Additional reflux caused by contractional malfunction of the sphincter leads to the reflux of gastrointestinal juice into the bile duct, bacterial infection of the bile duct and formation of pigment bile duct stones. 2,[5][6][7][8] The dysfunction of the SO (decrease of the pres sure) has been demonstrated in manometric studies. 9,10 The clinical result of the dysfunction of SO is the formation of CBD stones, infection (cholangitis) or pancreatic disease.…”

Section: Discussionmentioning

confidence: 99%

The clinical importance of different localizations of the papilla associated with juxtapapillary duodenal diverticula

et al. 2014

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Background: Previous studies have evaluated the presence of juxtapapillary duodenal diverticula (JPDD) and the association with pancreatobiliary disease, but not the asso ciation of the papilla with an existing JPDD. We investigated the association of differ ent localizations of the papilla with JPDD. Methods:We studied patients in whom JPDD was detected during endoscopic ret rograde cholangiopancreatography. Patients were classified into 3 groups: 1) papilla located inside the diverticulum, 2) papilla located at the edge of the diverticulum and 3) papilla located closer than 3 cm to the diverticulum. The patients were examined with respect to localization of papilla-diverticula and to the association of the localiza tion with pancreaticobiliary disease.

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Risk factors for recurrent bile duct stones after endoscopic papillotomy

Cited by 140 publications

References 30 publications

Size of recurrent symptomatic common bile duct stones and factors related to recurrence

Size of recurrent symptomatic common bile duct stones and factors related to recurrence

Risk factors of acute cholecystitis after endoscopic common bile duct stone removal

The clinical importance of different localizations of the papilla associated with juxtapapillary duodenal diverticula

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