Differences in Outcome and Comparison of Stress and Immune Status in Patients with Recurrent Common Bile Duct Stones after Biliary Tract Surgery Choosing Three Procedures (ERCP, OCBDE, and LCBDE) for Treatment

Objective. To compare the effect of choosing ERCP, OCBDE, and LCBDE for the treatment of patients with recurrent common bile duct stones after biliary tract surgery. Method. 115 patients with recurrent common bile duct stones after biliary surgery in our hospital were retrospectively analyzed and divided into three groups according to the procedure, 36 patients in the ERCP group, 38 patients in the OCBDE group, and 41 patients in the LCBDE group, and compared the efficacy, stress status, and immune status of the three groups. Result. The stone removal rates were 91.67%, 97.37%, and 97.56% in the ERCP, OCBDE, and LCBDE groups, respectively ( P > 0.05 ). There were statistical differences between the ERCP, OCBDE, and LCBDE groups in terms of operative time, postoperative recovery time of exhaustion, recovery time of defecation, recovery time of feeding, and hospitalization time ( P < 0.05 ). The postoperative complication rates were 8.33%, 10.53%, and 7.32% in the ERCP, OCBDE, and LCBDE groups, respectively ( P > 0.05 ). The recurrence rates within 1 year after surgery were 2.78%, 7.89%, and 2.44% in the ERCP, OCBDE, and LCBDE groups, respectively ( P > 0.05 ). Conclusion. ERCP has short operative time, short hospital stay, and rapid postoperative recovery. LCBDE has mild trauma, and OCBDE has a wide range of application. Each of the three procedures has its own advantages and shortcomings, and the most appropriate procedure should be selected on the basis of comprehensive evaluation.

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

Journal of International Medical Research ◽

10.1177/0300060518765605 ◽

2018 ◽

Vol 46 (7) ◽

pp. 2595-2605 ◽

Cited By ~ 4

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.

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