Surgical strategy for recurrent common bile duct stones: a 10-year experience of a single center

Hu, Xia; Xin, Xianlei; Yang, Tao; Liu, Yang; Liang, Bin; Wang, Jing

doi:10.1007/s13304-020-00882-8

Cited by 7 publications

(7 citation statements)

References 34 publications

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“…This modified Roux-en-Y hepaticojejunostomy has been performed at the authors' center for more than 10 years and achieves satisfactory therapeutic effects. The incidence of long-term complications of posthepaticojejunostomy decreased from about 30% (between 1993 and 2006, the long-term complications rate was 32.91% [51/158], unpublished data) to around 5% (after the modified procedure began to be performed) [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…There is currently no standard method for assessing the structure and function of the duodenal papilla. In this study, the assessment included intraoperative observation of the morphology of the duodenal papilla and the choledochoscopic pass-through test [ 12 ]. Morphological observation focused on the diameter of the common bile duct, inflammation of the inner wall of the common bile duct, the opening and closing function of the duodenal papilla, rhythmic contraction of the sphincter of Oddi, the confluence of the bile ducts and pancreatic duct, the presence of a fistula between the common bile duct and duodenum, and other obvious structural and functional abnormalities.…”

Section: Methodsmentioning

confidence: 99%

“…The purpose of extrahepatic bile duct resection is to address structure and function abnormalities of the sphincter of Oddi at the lower end of the common bile duct and hilar bile duct stenosis. Therefore, after extrahepatic bile duct resection, hilar ductoplasty [ 12 ] was performed to ensure the opening of the biliary-enteric anastomosis was of sufficient diameter to prevent postoperative complications. This was followed by a Roux-en-Y hepaticojejunostomy [ 12 ].…”

Section: Methodsmentioning

confidence: 99%

“…Therefore, after extrahepatic bile duct resection, hilar ductoplasty [ 12 ] was performed to ensure the opening of the biliary-enteric anastomosis was of sufficient diameter to prevent postoperative complications. This was followed by a Roux-en-Y hepaticojejunostomy [ 12 ].…”

Section: Methodsmentioning

confidence: 99%

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Surgical Management of Recurrence of Primary Intrahepatic Bile Duct Stones

Xia

Zhang

Xin

et al. 2023

Canadian Journal of Gastroenterology and Hepatology

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Background. The surgical treatment of primary intrahepatic bile duct stones is associated with high rates of postoperative complications, stone recurrence, and reoperation. This study aimed to report an 11-year experience in the management of postoperative recurrence of intrahepatic bile duct stones, analyze the causes of the reoperation, and establish appropriate surgical procedures. Materials and Methods. The records of 148 patients with postoperative recurrence of primary intrahepatic bile duct stones treated from January 2005 to December 2015 were retrospectively reviewed. Prior surgical treatment and postoperative data were analyzed to investigate possible causes of recurrence and reoperation. Results. All patients with a prior cholangiojejunostomy (n = 61) developed biliary stenosis (100%). Of the 86 patients without cholangiojejunostomy, 71 (82.56%) had abnormalities in the structure and function of the lower end of the common bile duct, and 86 had hilar and intrahepatic bile duct stenosis. Of all 148 patients, 136 (91.89%) had positive intraoperative bile cultures. Patients were treated with a modified surgical procedure, and the combined excellent and good rate of long-term outcomes reached 85.48% (106/124). The stone recurrence rate of the 124 patients decreased from 100% (124/124) of the prior operation to 5.65% (7/124) during the reoperation. Conclusions. The pathogenesis of primary intrahepatic bile duct stones is associated with biliary infection and intrahepatic bile duct cholestasis. According to the etiology and pathogenic mechanism, surgical procedures that improve long-term outcomes and reduce postoperative recurrence include bile duct exploration with stone extraction, partial hepatectomy, hilar ductoplasty, and Roux-en-Y hepaticojejunostomy.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Surgical Management of Recurrence of Primary Intrahepatic Bile Duct Stones

Xia

Zhang

Xin

et al. 2023

Canadian Journal of Gastroenterology and Hepatology

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“…Some studies have reported a recurrence rate of between 4% and 24%, and patients with recurrent bile duct stones are more susceptible to the reformation of subsequent stones ( 10 , 11 ). In one study, a patient underwent 13 ERCP + EST with CBDE procedures but still had reoccurring CBDS ( 12 ). Certain patients with multiple recurrences and a short recurrence interval are considered to have refractory recurrent bile duct stones.…”

Section: Introductionmentioning

confidence: 99%