Clinical endoscopy · 2025
Incidence and risk factors for recurrence of common bile duct stones in patients undergoing endoscopic extraction without prophylactic biliary stenting and subsequent cholecystectomy: a retrospective study in Japan.
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Sumiya Hidehito, Ogawa Takahisa, Koshita Shinsuke, Kanno Yoshihide, Kusunose Hiroaki, Sakai Toshitaka, Yonamine Keisuke, Miyamoto Kazuaki, Kozakai Fumisato, Okano Haruka, Matsuoka Yuto, Hosokawa Kento, Ito Kei
Аннотация
BACKGROUND: In patients undergoing endoscopic extraction of common bile duct stones (CBDs) and subsequent cholecystectomy, CBDs sometimes recur during the preoperative and perioperative periods. In this study, the incidence and risk factors for CBDs recurrence were investigated.
METHODS: A total of 245 patients (mean age: 66 years; 138 men) who underwent cholecystectomy within 180 days of CBDs extraction between October 2017 and June 2023 were included. Recurrence was defined as the detection of the CBDs during the preoperative or perioperative period using imaging modalities such as computed tomography or re-endoscopic retrograde cholangiopancreatography, regardless of the presence of cholangitis.
RESULTS: CBDs recurrence occurred in 4.1% of the patients (10/245). The median time to recurrence was 40 days. Preoperative recurrence was observed in nine patients, and only one patient had postoperative recurrence. Multivariate analysis identified cystic duct stones as the only significant risk factor for CBDs recurrence (hazard ratio, 15.6; 95% confidence interval, 3.7-66; p<0.001).
CONCLUSIONS: The risk of CBDs recurrence after endoscopic extraction during the pre and perioperative periods is high in patients with cystic duct stones. Prophylactic biliary stenting may be considered in high-risk patients.
METHODS: A total of 245 patients (mean age: 66 years; 138 men) who underwent cholecystectomy within 180 days of CBDs extraction between October 2017 and June 2023 were included. Recurrence was defined as the detection of the CBDs during the preoperative or perioperative period using imaging modalities such as computed tomography or re-endoscopic retrograde cholangiopancreatography, regardless of the presence of cholangitis.
RESULTS: CBDs recurrence occurred in 4.1% of the patients (10/245). The median time to recurrence was 40 days. Preoperative recurrence was observed in nine patients, and only one patient had postoperative recurrence. Multivariate analysis identified cystic duct stones as the only significant risk factor for CBDs recurrence (hazard ratio, 15.6; 95% confidence interval, 3.7-66; p<0.001).
CONCLUSIONS: The risk of CBDs recurrence after endoscopic extraction during the pre and perioperative periods is high in patients with cystic duct stones. Prophylactic biliary stenting may be considered in high-risk patients.