Factors predisposing to stone migration from the gallbladder into the common bile duct. Issue 1 (February 2017)

• Record Type: Journal Article
• Authors: Gan, Jonathan; Chang, Stephen
• Is Part Of: Surgical practice. Volume 21:Issue 1(2017:Feb.)
• Page Start: 8
• Page End: 12
• Publication Date: 2017-02
• Subjects: cholangitis -- endoscopic retrograde cholangiopancreatography -- gallstone -- laparoscopic cholecystectomy -- recurrence; Surgery -- Periodicals; Operations, Surgical -- Periodicals; 617.005
• DOI: 10.1111/1744-1633.12219
• Languages: English
• ISSNs: 1744-1625

Abstract

Abstract : Aim: Endoscopic retrograde cholangiopancreatography (ERCP), followed by laparoscopic cholecystectomy (LC), has an important role in the treatment of gallstone cholangitis. The aim of the present study was to investigate the optimal timing of LC, and factors that predispose early recurrence in patients who undergo ERCP for common bile duct (CBD) stones. Patients and Methods: A retrospective study was carried out for all patients who were treated conservatively in our hospital from 2006 to 2008. A total of 116 patients were followed up. Patients were divided into three groups: early recurrence, late recurrence and no recurrence. Risk factors evaluated included age, sex, number of stones, largest stone size, gallbladder wall thickness, CBD diameter, presence of stones in the gallbladder and CBD and the presence of pericholecystic fluid. Results: CBD stone recurrence occurred in 29 patients (25 per cent). Fifteen patients had recurrent symptoms within 2.6 months. These patients were subsequently placed in the early recurrence group. Multivariate analysis showed that lager stone size [odds ratio (OR): 1.084, 95 per cent confidence interval (CI): 1.007–1.167, P = 0.033] is a significant risk factor for early recurrence, but older age is a protective factor (OR: 0.994, CI: 0.907–0.984, P = 0.006). Conclusion: Gallstone size is significantly associated with early CBD stone recurrence. Advancing age is protective against early recurrence. LC should be performed within 2.6 months after the first event.