Multiple recurrences after endoscopic removal of common bile duct stones: A retrospective analysis of 976 cases.
Aged
Aged, 80 and over
Cholangiopancreatography, Endoscopic Retrograde
/ adverse effects
Choledocholithiasis
/ diagnostic imaging
Dilatation
Female
Humans
Incidence
Male
Middle Aged
Recurrence
Retrospective Studies
Risk Assessment
Risk Factors
Sphincterotomy, Endoscopic
/ adverse effects
Time Factors
Tokyo
/ epidemiology
Treatment Outcome
choledocholithiasis
endoscopic retrograde cholangiopancreatography
recurrence
transduodenal sphincteroplasty
transduodenal sphincterotomy
Journal
Journal of gastroenterology and hepatology
ISSN: 1440-1746
Titre abrégé: J Gastroenterol Hepatol
Pays: Australia
ID NLM: 8607909
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
19
12
2018
revised:
09
02
2019
accepted:
11
02
2019
pubmed:
15
2
2019
medline:
11
2
2020
entrez:
15
2
2019
Statut:
ppublish
Résumé
Recurrences after endoscopic treatment of common bile duct stones (CBDS) are common. The aims of this study were to identify risk factors for recurrences of CBDS and to evaluate the effect of interventions for prevention of further recurrences. A total of 976 patients who underwent endoscopic treatment of CBDS were retrospectively studied. Risk factors for single and multiple recurrent CBDS were evaluated using a Cox hazard regression model. The incidences of further recurrences were evaluated according to the additional interventions. The mean age was 69.3 years, and 39.3% were female. Endoscopic papillary balloon dilation, endoscopic sphincterotomy, and endoscopic papillary large balloon dilation were performed in 858, 77, and 41 patients, respectively. The rates of one or more recurrence and multiple recurrences of CBDS were 12.4% and 2.7%, respectively. In the multivariate analyses, the significant risk factors were the bile duct size (hazard ratio [HR] 1.07, P = 0.012), gallbladder left in situ with stones (HR 1.91, P = 0.046), and pneumobilia after treatment (HR 2.10, P = 0.047) for single recurrence and the number of stones at the first recurrence (HR 1.16, P = 0.021) for multiple recurrences. In five out of nine cases with multiple recurrences, further recurrence was not observed after additional sphincteroplasty in addition to cholecystectomy. The incidence of multiple recurrences was not uncommon after the first recurrence of CBDS.
Sections du résumé
BACKGROUND AND AIM
OBJECTIVE
Recurrences after endoscopic treatment of common bile duct stones (CBDS) are common. The aims of this study were to identify risk factors for recurrences of CBDS and to evaluate the effect of interventions for prevention of further recurrences.
METHODS
METHODS
A total of 976 patients who underwent endoscopic treatment of CBDS were retrospectively studied. Risk factors for single and multiple recurrent CBDS were evaluated using a Cox hazard regression model. The incidences of further recurrences were evaluated according to the additional interventions.
RESULTS
RESULTS
The mean age was 69.3 years, and 39.3% were female. Endoscopic papillary balloon dilation, endoscopic sphincterotomy, and endoscopic papillary large balloon dilation were performed in 858, 77, and 41 patients, respectively. The rates of one or more recurrence and multiple recurrences of CBDS were 12.4% and 2.7%, respectively. In the multivariate analyses, the significant risk factors were the bile duct size (hazard ratio [HR] 1.07, P = 0.012), gallbladder left in situ with stones (HR 1.91, P = 0.046), and pneumobilia after treatment (HR 2.10, P = 0.047) for single recurrence and the number of stones at the first recurrence (HR 1.16, P = 0.021) for multiple recurrences. In five out of nine cases with multiple recurrences, further recurrence was not observed after additional sphincteroplasty in addition to cholecystectomy.
CONCLUSIONS
CONCLUSIONS
The incidence of multiple recurrences was not uncommon after the first recurrence of CBDS.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1460-1466Informations de copyright
© 2019 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.
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