The correlation between the composition of choledocholithiasis and the duodenal gastroesophageal reflux after endoscopic sphincterotomy

Abstract

Objective To investigate the correlation between the composition of common bile duct stones and postoperative duodenal gastroesophageal reflux(DGER)after endoscopic sphincterotomy(EST). Methods A prospective study of 82 patients underwent EST from January 2016 to June 2017 in the people′s hospital of Xinjiang Uygur Autonomous Region was carried out, collected clinical data, and divided all patien into 3 groups according to the composition of choledocholithiasis, including bile pigment stone group(group A), cholesterol stone group(group B)and mixed stones group(group C), gastroesophageal reflux disease questionnaire(GERD-Q), 24 h esophageal pH and bile joint detection were compared between the 3 groups before and after 1 weeks of operation, and analysis of the relationship between the composition of choledocholithiasis and DGER. Results GERD-Q score, frequency of reflux>5 minutes, and time percentage of absorbance value>0.14 in group A were significantly higher than that of B and C groups(P 0.14 in group C were significantly higher than that of group B(P 5 minutes and acid reflux in 24 h, time percentage of absorbance value>0.14 of the three groups were all significantly higher than those before the operation(P<0.05). Conclusion After EST the incidence rate of DGER was higher than preoperative, the symptoms were more obvious.Occurrence of GERD was closely related to the composition of choledocholithiasis, patients with bile pigment stones have higher DGER severity after EST, followed by mixed stone patients.However, the internal mechanism of choledocholithiasis and the occurrence of DGER need to be further studied in a multi center and large sample. Key words: Duodenal gastroesophageal reflux; Endoscopic sphincterotomy; Choledocholithiasis; stone composition