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Abstract
Background/Aims
We aimed to explore the risk factors contributing to the recurrence of common bile duct (CBD) stones after successful endoscopic stone clearance, focused on the anatomical factors of CBD and presence or absence of ursodeoxycholic acid (UDCA)/RowacholⓇ medication.
Methods
One hundred fourteen patients who underwent CBD stone(s) extraction by endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy at our institution from August 2004 to January 2007 were included. Univariate and multivariate analyses for the risk factors including the distal CBD angle, length of the distal CBD arm and medication such as ursodeoxycholic acid (UDCA) and/or RowacholⓇ for recurrent CBD stone(s) were performed.
Results
The recurrence of CBD stone(s) was found in 22 (19.3%) patients. On univariate analysis, presence of pneumobilia, presence of type 1 or type 2 periampullary diverticulum, mechanical lithotripsy and multiple sessions of ERCP were significant contributors for the recurrence of CBD stone(s). On multivariate analysis, the presence of type 1 periampullary diverticulum (OR 7.90, 95% CI: 1.56-40.16) and multiple sessions of ERCP (OR 7.56, 95% CI: 2.21-25.87) were significant contributors. Acute distal CBD angulation (≤135 o), shorter distal CBD arm (≤36 mm), technical difficulty of CBD stone(s) clearance, and the prescription of UDCA and/or RowacholⓇ were not significantly associated with the recurrence of CBD stone(s).
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Table 1.
Clinical Characteristics of Patients and ERCP Findings (n=114)∗
Table 2.
Univariate Analysis of Risk Factors for Recurrent Common Bile Duc ct Stones (n=114)∗
Table 3.
Multivariate Analysis of Risk Factors for Recurrent Common Bile Duct Stones
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