scholarly journals Risk Factors for Recurrence of Symptomatic Common Bile Duct Stones after Cholecystectomy

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Ju Hyun Oak ◽  
Chang Nyol Paik ◽  
Woo Chul Chung ◽  
Kang-Moon Lee ◽  
Jin Mo Yang
Keyword(s):  
Risk Factors ◽  
Bile Duct ◽  
Bile Duct Stones ◽  
Cbd Stones ◽  
Number Of Patients ◽  
Periampullary Diverticulum ◽  
Risk Factors For Recurrence ◽  
The Mean ◽  
Cbd Stone

Purpose. The recurrence of CBD stone is still observed in a considerable number of patients. The study was to evaluate the risk factors for recurrence of symptomatic CBD stone in patients who underwent cholecystectomy after the removal of CBD stone.Methods. The medical records of patients who underwent removal of CBD stone with subsequent cholecystectomy were reviewed. The risk factors for the recurrence of symptomatic CBD stone were compared between the recurrence and the nonrecurrence group.Results. The mean follow-up period was 40.6 months. The recurrence of symptomatic CBD stones was defined as the detection of bile duct stones no sooner than 6 months after complete clearance of CBD stones, based on symptoms or signs of biliary complication. 144 patients (68 males, 47.2%) were finally enrolled and their mean age was 59.8 (range: 26~86) years. The recurrence of CBD stone occurred in 15 patients (10.4%). The mean period until first recurrence was 25.9 months. The presence of type 1 or 2 periampullary diverticulum and multiple CBD stones were the independent risk factors.Conclusion. For the patients with type 1 or 2 periampullary diverticulum or multiple CBD stones, careful followup is needed for the risk in recurrence of symptomatic CBD stone.

scholarly journals Factors Significantly Contributing to a Failed Conventional Endoscopic Stone Clearance in Patients with “Difficult” Choledecholithiasis: A Single-Center Experience

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Emmanuel Christoforidis ◽  
Konstantinos Vasiliadis ◽  
Konstantinos Tsalis ◽  
Dimitrios Patridas ◽  
Konstantinos Blouhos ◽  
...  
Keyword(s):  
Bile Duct ◽  
Endoscopic Sphincterotomy ◽  
Statistical Tests ◽  
Bile Duct Stones ◽  
Stone Extraction ◽  
Contributing Factors ◽  
Stone Clearance ◽  
Cbd Stones ◽  
Single Center Experience ◽  
Cbd Stone

The objective of this study is to retrospectively evaluate factors significantly contributing to a failed stone extraction (SE) in patients with difficult to extract bile duct stones (BDS). Patients and Methods. During a 10-year period 1390 patients with BDS underwent successfully endoscopic sphincterotomy. Endoscopic SE was graded as easy; relatively easy; difficult; and failed. Difficult SE was encountered in 221 patients while failed SE was encountered in 205. A retrospective analysis of the criteria governing the difficulty of endoscopic SE following the index endoscopic intervention was performed to evaluate their significance in determining failure of complete SE among patients with difficult to extract bile duct stones. Results. Age ≥ 85 years, periampullary diverticula, multiple CBD stones (>4), and diameter of CBD stones (≥15 mm) were all significant contributing factors to a failed SE in univariate statistical tests. In the definitive multivariate analysis age, multiple stones and diameter of stones were found to be the significant, independent contributors. Conclusion. Failed conventional endoscopic stone clearance in patients with difficult to extract BDS is more likely to occur in overage patients, in patients with multiple CBD stones >4, and in patients with CBD stone(s) diameter ≥15 mm.

scholarly journals Risk factors for recurrence of common bile duct stones after endoscopic biliary sphincterotomy

2018 ◽  
Vol 46 (7) ◽  
pp. 2595-2605 ◽  
Author(s):  
Sujuan Li ◽  
Bingzhong Su ◽  
Ping Chen ◽  
Jianyu Hao
Keyword(s):  
Risk Factors ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Biliary Tract ◽  
Common Bile Duct Stones ◽  
Bile Duct Stones ◽  
Endoscopic Biliary Sphincterotomy ◽  
Biliary Tract Surgery ◽  
Biliary Sphincterotomy ◽  
Risk Factors For Recurrence

Objective Late complications after endoscopic biliary sphincterotomy (EST) include stone recurrence, but no definite risk factors for recurrence have been established. This study was performed to identify the predictors of recurrence and evaluate the clinical outcomes of EST for common bile duct stones. Methods In total, 345 eligible patients who successfully underwent EST were evaluated and followed up. Statistical analysis was performed on patients with recurrence or who had undergone at least 6 months of reliable follow-up to detect the risk factors for recurrence. Results A total of 57 patients (16.52%) developed recurrence of common bile duct stones. The median length of time until recurrence was 10.25 months (range, 6–54.4 months). Univariate analyses showed that the following factors were associated with recurrence: cholecystectomy prior to EST, prior biliary tract surgery, periampullary diverticulum, diameter of the common bile duct (>15 vs. ≤15 mm), quantity of stones, complete stone removal at the first session, and lithotripsy. Multivariate analysis identified two independent risk factors for recurrence: previous biliary tract surgery and lithotripsy. Conclusions EST for common bile duct stones is safe as indicated by patients’ long-term outcomes. Patients with a history of biliary surgery or lithotripsy are more prone to recurrence.

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

2001 ◽  
Vol 54 (1) ◽  
pp. 42-48 ◽  
Author(s):  
Dong Il Kim ◽  
Myung-Hwan Kim ◽  
Sung Koo Lee ◽  
Dang Wan Seo ◽  
Won Boem Choi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bile Duct ◽  
Bile Duct Stones ◽  
Endoscopic Biliary Sphincterotomy ◽  
Biliary Sphincterotomy ◽  
Risk Factors For Recurrence

scholarly journals Evaluation of different methods of laparoscopic treatment of common bile duct stones

2019 ◽  
Vol 6 (8) ◽  
pp. 2670
Author(s):  
Elghamry E. Elghamry ◽  
Mohamed M. Elsheikh ◽  
Hamdy A. Mohamed
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Primary Repair ◽  
Common Bile Duct Stones ◽  
Bile Leakage ◽  
Biliary Colic ◽  
Bile Duct Stones ◽  
Cbd Stones ◽  
The Mean ◽  
Cbd Exploration

Background: Common bile duct (CBD) stones are the second most common complication of gall bladder stones. The best management of patients with CBD stones remains controversial. The aim of this study was to evaluate the methods of laparoscopic CBD exploration (LCBDE).Methods: This prospective study was conducted on 30 patients with CBD stones through 2 years. CBD stricture was excluded. Authors used transcystic and transcholedochotomy approaches for LCBDE either with or without choledoschope. Primary repair of the choledochotomy incision was done. Results: The mean age was 48.90±11.84 years. Biliary colic was the presentation in 63.3% of patients. The transcystic approach for CBD exploration was used in 16 cases without conversion, 11 cases were completed without choledochoscope, while 5 cases with choledochoscopic guided extraction. Choledochotomy approach had been used in 13 cases, 6 cases were completed with choledochoscope and 7 cases without it, two cases of them failed. One case failed from the beginning and was converted to open exploration. 5 ERCP previously inserted stents were removed. The mean operative time was 162.33±74.67 min. Bile leakage occurred in 2 cases following the choledochotomy approach. The mean hospital stay was 3.37±1.38 days.Conclusion: LCBDE is a feasible, effective and safe approach to bile duct stones. Depending on proper training and gaining experience. 

scholarly journals LAPAROSCOPIC MANAGEMENT OF COMMON BILE DUCT STONES

2020 ◽  
pp. 1-4
Author(s):  
Binit Prasad ◽  
Mukesh Kumar ◽  
Debarshi Jana
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Open Surgery ◽  
Common Bile Duct Stones ◽  
Single Stage ◽  
Bile Duct Stones ◽  
Cbd Stones ◽  
Cbd Stone ◽  
Laparoscopic Cbd Exploration ◽  
Cbd Exploration

Introduction: Common Bile Duct stones (CBD) are found in approximately 16% of the patients undergoing Laparoscopic cholecystectomy (LC). Till recently, the gold standard for treating CBD stones was endoscopic removal, if that failed, then open surgery. However, in the laparoscopic era, the best treatment for CBD stones is a matter of debate and it continues to evolve. The objective of the present study is to determine that laparoscopic CBD exploration (LCBDE) is a safe, feasible and single-stage option for the management of CBD stones. Materials and Methods :Out of the 2900 laparoscopic cholecystectomies we did selective intraoperative cholangiogram in 262 patients who were suspected to have CBD stones based on deranged liver function tests, dilated CBD with or without CBD stone on sonography or having the history of recent jaundice/pancreatitis. If CBD stone was found, either a transcystic or transcholedochal exploration was done depending on the size, site, number of stones and CBD diameter. Choledochotomy was closed over a t-tube in the majority of the patients. Primary closure of CBD was done in few patients and in one patient we placed an antegrade stent and in another we placed endoscopic stent into the CBD laparoscpically which was removed after four weeks. Results :Till date we have performed LCBDE in 64 patients. Transcystic exploration was done in 14 patients and transcholedochal exploration was done in 46 cases out of which 2 patients had minor biliary leak which settled on conservative treatment in 2-3 days. Four patients required conversion to open surgery as there were multiple stones. We did not have any major complication and on 6 months follow-up in 76% patients, none was found to have residual stone. Conclusion :The treatment of CBD stones depends on the resources available, technical limitations and the surgeon’s expertise. Laparoscopic CBD exploration is a safe, feasible and single-stage option for the management of CBD stones.

scholarly journals Common bile duct stones: its different aspects of presentation and management

2020 ◽  
Vol 7 (7) ◽  
pp. 2289
Author(s):  
Nishant Kumar
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stones ◽  
Medical Sciences ◽  
Radiological Findings ◽  
Cbd Stones ◽  
The Mean ◽  
Cbd Stone ◽  
Surgery Department ◽  
Potential Challenge

Background: Common bile duct (CBD) stone management is a commonly occurring potential challenge for surgeons.Methods: A total of 38 patients who was admitted in admitted in surgery Department of Sri Ram Institute of Medical Sciences, Bareilly UP during the period of March 2019 to September 2019 were studied. The diagnosis was made using USG MRCP, relevant blood investigations. Patients were managed based on radiological findings by the best possible way and expertise available.Results: Out of the 38 patients, 14 (37.14%) were male and 24 (62.85%) were female. The mean age for male was 50.92 years and for female, it was 51.74 yrs. Most of the patients had pain abdomen and /or jaundice with a mean total bilirubin of 3 mg/dl. Patients are managed either by ERCP or by surgery (open/laparoscopic). Mortality is nil but morbidity is more for open procedures.Conclusions: There can be no definite algorithm for the management of CBD stones as the patients’ age, underlying general condition being the only standardizable factor with facilities for endoscopic, laparoscopic management being variably available from institution to institution and hence, necessitating tailoring the management of CBD stones depending upon the Institution’s resources.

scholarly journals Clinical Outcomes of Digital Cholangioscopy-Guided Procedures for the Diagnosis of Biliary Strictures and Treatment of Difficult Bile Duct Stones: A Single-Center Large Cohort Study

2021 ◽  
Vol 10 (8) ◽  
pp. 1638
Author(s):  
Hirohito Minami ◽  
Shuntaro Mukai ◽  
Atsushi Sofuni ◽  
Takayoshi Tsuchiya ◽  
Kentaro Ishii ◽  
...  
Keyword(s):  
Bile Duct ◽  
Adverse Events ◽  
Clinical Outcomes ◽  
Significant Risk ◽  
Histopathological Analysis ◽  
Bile Duct Stones ◽  
Serious Adverse Events ◽  
Visualization System ◽  
Visual Impression ◽  
Number Of Patients

Although Spy DS (SpyGlass DS Direct Visualization System) is considered to be useful for the diagnosis of bile duct strictures and the treatment of bile duct stones, there is limited data to date validating its efficacy. We hence retrospectively evaluated the clinical outcomes of the use of Spy DS in a large number of patients. A total of 183 patients who underwent Spy DS-guided procedures for indeterminate bile duct strictures (n = 93) and bile duct stones (n = 90) were analyzed retrospectively. All patients (93/93) with bile duct strictures successfully underwent visual observation, and 95.7% (89/93) of these patients successfully underwent direct biopsy. The sensitivity, specificity, and overall accuracy were 94.7%, 83.3%, and 90.3%, respectively, for visual impression; 80.9%, 100%, and 89.2%, respectively, for histopathological analysis of a direct biopsy; and 96.5%, 91.7%, and 94.6%, respectively, for visual impression combined with biopsy. Successful visualization of the stones was achieved in 98.9% (89/90) of the patients, and complete stone removal was achieved in 92.2% (83/90) of the patients, with an average of 3.3 procedures. The adverse events rate was 17.5% (32/183; cholangitis in 15 patients, fever the following day in 25, pancreatitis in 1, hemorrhage in 1, and gastrointestinal perforation in 1). No administration of antibiotics before the procedure was found to be a statistically significant risk factor for the development of fever after the procedure (p < 0.01). Spy DS-guided procedures are effective for the diagnosis and treatment of bile duct lesions and can be performed with a low risk of serious adverse events.

Sign in / Sign up

Export Citation Format

Share Document