Analysis of the Risk Factors for Cholangitis Occurring after Treatment of Hepatolithiasis

Cheon, Jae Hee; Kim, Jin; Kim, Yong Tae; Yoon, Yong Bum; Kim, Chung Yong

Abstract

BACKGROUND/AIMS: Hepatolithiasis usually causes critical complications. Particularly, recurrent cholangitis is developed even after treatment. In this study, we aimed to find out the risk factors for recurrent cholangitis after management of hepatolithiasis.
METHODS
We reviewed the medical records of 196 patients with hepatolithiasis who had been diagnosed newly and treated at Seoul National University Hospital between January 1980 and August 2000. Then, the cumulative rate of cholangitis after treatment of hepatolithiasis and the possible risk factors for cholangitis through univariate and multivariate analysis were evaluated.
RESULTS
The cumulative rate of cholangitis of all patients was 9.6%/patient-year. Univariate analysis revealed that the presence of residual stone after treatment (P <0.0001), common bile duct stone before treatment (p=0.0066), stone recurrence after treatment (p=0.0014), and disruption of the sphincter of Oddi (p=0.0046) were significantly associated with recurrent cholangitis. By multivariate analysis using Cox model, the presence of residual stones, recurrence of stones, and the disruption of sphincter of Oddi were turned out to be the independent risk factors, but the presence of common bile duct stones was not.
CONCLUSIONS
Complete removal of bile duct stone, prevention of recurrent stones, and preservation of the sphincter of Oddi can decrease the rate of cholangitis in patients with hepatolithiasis.