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Risk factors for recurrence of primary bile duct stones after endoscopic biliary sphincterotomy.

Abstract：

BACKGROUND:Endoscopic biliary sphincterotomy (EST) is a well-established procedure for bile duct stone extraction. Bile duct stones can be classified as primary or secondary. However, few data are available on the recurrence of primary and secondary bile duct stones after EST. Therefore risk factors for the recurrence of primary bile duct stones after EST were prospectively studied. METHODS:Between 1991 and 1997, 61 patients underwent EST for primary bile duct stones. All met the following criteria: (1) previous cholecystectomy without bile duct exploration, (2) detection of bile duct stones at least 2 years after initial cholecystectomy. Mean follow-up was 2.2 years. Fourteen patients were lost to follow-up. The recurrence of primary bile duct stones was defined as the detection of bile duct stones no sooner than 6 months after complete clearance of primary bile duct stones. RESULTS:The overall recurrence rate of primary bile duct stones was 21% (10 of 47). Two significant risk factors for recurrence were identified by multivariate analysis: (1) patients with a bile duct diameter of 13 mm or greater after stone removal had recurrences more frequently than those with a duct diameter of 13 mm or less, and (2) patients whose papilla was located on the inner rim or deep within a diverticulum, so that the papillary orifice was not visible endoscopically, had more frequent recurrences than patients with a papilla outside the diverticulum, or no peripapillary diverticulum. CONCLUSION:The independent risk factors for recurrence of primary bile duct stones were sustained dilation of the bile duct even after complete removal of stones and location of the papilla on the inner rim or deep within a diverticulum.

journal_name

Gastrointest Endosc

journal_title

Gastrointestinal endoscopy

authors

Kim DI,Kim MH,Lee SK,Seo DW,Choi WB,Lee SS,Park HJ,Joo YH,Yoo KS,Kim HJ,Min YI

doi

10.1067/mge.2001.115335

keywords:

subject

Has Abstract

pub_date

2001-07-01 00:00:00

pages

42-8

issue

1

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(01)07022-5

journal_volume

54

pub_type

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