Factor Influencing the Recurrence of CBD Stones after an Endoscopic Sphincteromy

Kang, Jin Kyung; Park, In Suh; Chung, Jae Bock; Moon, Young Myoung; Kim, Hyung Gil; Song, Si Young; Lee, Jin Heon; Cheong, Jae Youn; Jung, Bai Gi

Abstract

BACKGROUND AND AIMS
Long term results of an endoscopic sphincterotomy (EST) have still been poorly estimated. The aim of this study was to assess late complications of EST.
METHODS
The rate of late complications were retrospectively evaluated in with 91 patients (mean age, 59.1 years; range, 28~86 years; M:F, 44:47), who underwent EST for choledocholithiasis.
RESULTS
Forty six patients (50.5%) had their gallbladder in situ, and 45 patients (49.5%) underwent cholecystectomy. Early complications (<30 days) such as hemorrhage, pancreatitis, and perforation occurred in 7 patients (7.7%). During a mean period of 53.4 months (range, 24~134 months), 26 patients (28.0%) developed late complications, including a recurrence of CBD stones in 20 patients (22.0%) (8-gallbladder in situ, 12-cholecystectomized). An univariate analysis of risk factors for stone recurrence revealed dilated ducts, stone sizes, and stone numbers which were not related with stone recurrence. The history of choledocholithotomy with cholecystectomy was significantly related to stone recurrence.
CONCLUSIONS
After EST for bile duct stones, late complications occurred in a significant proportion of patients and it was determined that a history of choledocholithotomy with cholecystectomy was significantly correlated with stone recurrence.