Risk factors for recurrent common bile duct stones after ERCP

Abstract

Objective To reveal the related risk factors of recurrent common bile duct （CBD） stones after ERCP. Methods Collected the patients data who underwent ERCP from January 2009 to December 2009 for CBD stones. The factors including gender, age, body mass index （BMI） , initial course of disease, history of biliary tract surgery, gallstones, papillary diverticulum, diameter of CBD, number of stones, size of stone and biliary stricture were compared between patients with recurrent CBD stone （recurrent group） or without （control group） by comparative analysis and multivariate logistic regression analysis. Results A total of 190 patients were followed up with a mean duration of 2. 3 years, with 68 patients in recurrent group and 122 in control. The comparative analysis showed that age （ 65.5 ± 15.5 yr vs. 57.6 ± 15.4 yr,P = 0. 001 ） , initial course of disease （ P = 0. 015 ） , history of biliary tract surgery （ 17.6% vs. 2. 5% ,P = 0. 000 ）, papillary diverticulum （ 29.4% vs. 7. 4%, P = 0. 000 ）, diameter of CBD （ 15.0 ± 5.1 mm vs. 10.7 ±3.4 mm,P =0. 001 ） , number of stones≥2 （80. 9% vs. 72. 9% ,P =0. 000） , diameter ofstone≥10 mm （35.3% vs. 8.2%,P=0.000） and biliary stricture （32.3% vs. 13.9%, P=0. 000） were statistically different between 2 groups. Multivariate analysis showed an older age （ OR = 3.44,95% CI： 1.55-7.63,P = 0. 002） , previous biliary surgery （OR = 5.82,95 % CI：I. 34-25.29,P = 0. 019） , having papillary diverticulum （ OR = 3.29,95 % CI： 1.18-9. 12, P = 0. 022 ）, diameter of CBD ≥ 10 mm（ OR = 4. 30, 95 % CI： 1.72-10. 72, P = 0. 002 ） , number of stones ≥ 2 （ OR = 4. 24,95 % CI： 1.61-11.16, P = 0. 003 ） are independent risk factors for recurrence of CBD stones. Conclusion An older age, previous biliary surgery history, papillary diverticulum, diameter of CBD ≥ 10 mm and number of stones ≥ 2 are independent risk factors for recurrence of CBD stones. Key words: Cholangiopancreatography, endoscopic retrograde ; Choledocholithiasis ; Recur-rence ; Risk factors ; Comparative study