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New common bile duct morphological subtypes: Risk predictors of common bile duct stone recurrence

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is the primary treatment for removing common bile duct (CBD) stones. The risk factors for CBD stone recurrence after ERCP have been discussed for many years. However, the influence of CBD morphology has never been noticed. AIM: To eva...

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Autores principales: Ji, Xu, Yang, Zhuo, Ma, Shu-Ren, Jia, Wen, Zhao, Qian, Xu, Lu, Kan, Ying, Cao, Yang, Wang, Yao, Fan, Bao-Jun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8984516/
https://www.ncbi.nlm.nih.gov/pubmed/35432763
http://dx.doi.org/10.4240/wjgs.v14.i3.236
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author Ji, Xu
Yang, Zhuo
Ma, Shu-Ren
Jia, Wen
Zhao, Qian
Xu, Lu
Kan, Ying
Cao, Yang
Wang, Yao
Fan, Bao-Jun
author_facet Ji, Xu
Yang, Zhuo
Ma, Shu-Ren
Jia, Wen
Zhao, Qian
Xu, Lu
Kan, Ying
Cao, Yang
Wang, Yao
Fan, Bao-Jun
author_sort Ji, Xu
collection PubMed
description BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is the primary treatment for removing common bile duct (CBD) stones. The risk factors for CBD stone recurrence after ERCP have been discussed for many years. However, the influence of CBD morphology has never been noticed. AIM: To evaluate CBD morphology and other predictors affecting CBD stone recurrence in average patients. METHODS: A retrospective analysis of 502 CBD stone patients who underwent successful therapeutic ERCP for stone extraction at our centre from February 2020 to January 2021 was conducted. CBD morphology and other predictors affecting CBD stone recurrence were examined by univariate analysis and multivariate logistic regression analysis. RESULTS: CBD morphology (P < 0.01), CBD diameter ≥ 1.5 cm [odds ratio (OR) = 2.20, 95%CI: 1.08-4.46, P = 0.03], and endoscopic biliary sphincterotomy with balloon dilation (ESBD) (OR = 0.35, 95%CI: 0.17-0.75, P < 0.01) are three independent risk factors for CBD stone recurrence. Furthermore, the recurrence rate of patients with the S type was 6.61-fold that of patients with the straight type (OR = 6.61, 95%CI: 2.61-16.77, P < 0.01). The recurrence rate of patients with the polyline type was 2.45-fold that of patients with the straight type (OR = 2.45, 95%CI: 1.14-5.26, P = 0.02). The recurrence rate of S type patients was 2.70-fold that of patients with the polyline type (OR = 2.70, 95%CI: 1.08-6.73, P = 0.03). Compared with no-ESBD, ESBD could decrease the risk of recurrence. CONCLUSION: CBD diameter ≥ 1.5 cm and CBD morphology, especially S type and polyline type, were associated with increased recurrence of CBD stones. In addition, ESBD was related to decreased recurrence. Patients with these risk factors should undergo periodic surveillance and standard prophylactic therapy.
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spelling pubmed-89845162022-04-15 New common bile duct morphological subtypes: Risk predictors of common bile duct stone recurrence Ji, Xu Yang, Zhuo Ma, Shu-Ren Jia, Wen Zhao, Qian Xu, Lu Kan, Ying Cao, Yang Wang, Yao Fan, Bao-Jun World J Gastrointest Surg Retrospective Study BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is the primary treatment for removing common bile duct (CBD) stones. The risk factors for CBD stone recurrence after ERCP have been discussed for many years. However, the influence of CBD morphology has never been noticed. AIM: To evaluate CBD morphology and other predictors affecting CBD stone recurrence in average patients. METHODS: A retrospective analysis of 502 CBD stone patients who underwent successful therapeutic ERCP for stone extraction at our centre from February 2020 to January 2021 was conducted. CBD morphology and other predictors affecting CBD stone recurrence were examined by univariate analysis and multivariate logistic regression analysis. RESULTS: CBD morphology (P < 0.01), CBD diameter ≥ 1.5 cm [odds ratio (OR) = 2.20, 95%CI: 1.08-4.46, P = 0.03], and endoscopic biliary sphincterotomy with balloon dilation (ESBD) (OR = 0.35, 95%CI: 0.17-0.75, P < 0.01) are three independent risk factors for CBD stone recurrence. Furthermore, the recurrence rate of patients with the S type was 6.61-fold that of patients with the straight type (OR = 6.61, 95%CI: 2.61-16.77, P < 0.01). The recurrence rate of patients with the polyline type was 2.45-fold that of patients with the straight type (OR = 2.45, 95%CI: 1.14-5.26, P = 0.02). The recurrence rate of S type patients was 2.70-fold that of patients with the polyline type (OR = 2.70, 95%CI: 1.08-6.73, P = 0.03). Compared with no-ESBD, ESBD could decrease the risk of recurrence. CONCLUSION: CBD diameter ≥ 1.5 cm and CBD morphology, especially S type and polyline type, were associated with increased recurrence of CBD stones. In addition, ESBD was related to decreased recurrence. Patients with these risk factors should undergo periodic surveillance and standard prophylactic therapy. Baishideng Publishing Group Inc 2022-03-27 2022-03-27 /pmc/articles/PMC8984516/ /pubmed/35432763 http://dx.doi.org/10.4240/wjgs.v14.i3.236 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Retrospective Study
Ji, Xu
Yang, Zhuo
Ma, Shu-Ren
Jia, Wen
Zhao, Qian
Xu, Lu
Kan, Ying
Cao, Yang
Wang, Yao
Fan, Bao-Jun
New common bile duct morphological subtypes: Risk predictors of common bile duct stone recurrence
title New common bile duct morphological subtypes: Risk predictors of common bile duct stone recurrence
title_full New common bile duct morphological subtypes: Risk predictors of common bile duct stone recurrence
title_fullStr New common bile duct morphological subtypes: Risk predictors of common bile duct stone recurrence
title_full_unstemmed New common bile duct morphological subtypes: Risk predictors of common bile duct stone recurrence
title_short New common bile duct morphological subtypes: Risk predictors of common bile duct stone recurrence
title_sort new common bile duct morphological subtypes: risk predictors of common bile duct stone recurrence
topic Retrospective Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8984516/
https://www.ncbi.nlm.nih.gov/pubmed/35432763
http://dx.doi.org/10.4240/wjgs.v14.i3.236
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