Risk Factors for Recurrence of Common Bile Duct Stones after Common Bile Duct Exploration Surgery

Abstract

Purpose: Recurrent common bile duct (CBD) stone is a significant delayed complication after CBD exploration surgery. However, no definite risk factors for recurrence have been established. The aim of this study is to identify the risk factors of recurrent CBD stone following surgical CBD stone removal. Methods: In total, 253 patients who underwent CBD exploration surgery from Jan 2000 to Jan 2018 were identified and included in this study. We retrospectively collected clinical data based on the medical records of the patients and investigated risk factors with logistic regression analysis. Results: A total of 31 patients (12.3%) developed recurrent CBD stones. The median follow-up period was 9.6 months. Univariate analyses showed that the following factors were associated with recurrent CBD stones: delayed diet start after 7 days, longer hospital duration, and preoperative endoscopic sphincterotomy. However, sex, age, gallstone, operation time, transfusion, T-tube insertion, and postoperative complications were not associated with recurrent CBD stone. In multivariate analysis, longer hospital duration and preoperative endoscopic sphincterotomy were associated with recurrent CBD stone (OR = 1.047; CI 1.001 to 1.095; p = 0.048 and OR = 3.615; CI 1.081 to 12.087; p = 0.037, respectively). Conclusion: Recurrent CBD stones can often occur and require regular follow-up although it is safe to remove by surgical CBD exploration. Further investigation is needed on the risk factors of recurrent CBD stones.