An angulated common bile duct predisposes to recurrent symptomatic bile duct stones after endoscopic stone extraction.

摘要: Endoscopic sphincterotomy and stone extraction are standard procedures for the removal of bile duct stones. Stone recurrence can, however, occur in up to 25% cases. Risk factors have been poorly defined, but believed be related stasis. This study investigated whether an angulated common (CBD) that may predispose stasis influences symptomatic after successful endoscopic therapy. included 232 consecutive patients (mean age, 64.1 years; 86 men) who had undergone therapeutic retrograde cholangiopancreatography Data from follow-up period (36 ± 17 months) were obtained medical records patient questioning. Common angulation diameter measured cholangiogram removal. Symptomatic stones recurred 16% (36/232). Three independent risk identified by multivariate analysis: CBD (angle, ≤145°; relative [RR], 5.2; 95% confidence interval [CI], 2.2–12.5; p = 0.0002), a dilated (diameter, ≥13 mm; RR, 2.6; CI, 1.2–5.7; 0.017), previous open cholecystectomy (RR, 2.7; 1.3–5.9; 0.0117). Gender, urgency procedure, or periampullary diverticulum did not influence rate. Angulation (≤145°) on cholangiography, CBD, The findings support role recurrence. Further studies using these data prospectively identify high-risk warranted.