4639 The risk factors for the recurrence of primary common bile duct stones after endoscopic biliary sphincterotomy.

Abstract

Background: Endoscopic biliary sphincterotomy (EST) is a well-established procedure for removing common bile duct (CBD) stones. CBD stones can be clssified into primary and secondary stones. However, few data are available on the recurrence of primary and secondary CBD stones after EST, respectively. We therefore studied risk factors prospectively for the recurrence of primary CBD stones after EST. METHODS: Between 1991 and 1997, 47 patients underwent endoscopic sphincterotomy for primary CBD stones. They were included in primary CBD stones which had the following criteria; 1) previous cholecystectomy without surgical CBD exploration 2) the detection of CBD stones at least two years after initial cholecystectomy. The results of 47 cases were analyzed prospectively and mean follow-up was 2.3 years. The recurrence of primary CBD stones was defined as the detection of stones at least 6 months after complete removal of stones. Results: The recurrence rate of primary CBD stones was 21% (10 of 47). The cumulative recurrence rate increased over time, and reached 60% at 4 years after EST. Two significant risk factors for the recurrence of primary CBD stones were identified in a multivariate analysis. first, patients with CBD stones ≥13 mm in post-stone removal state relapsed more frequently than those with CBD diameter