내시경적 유두괄약근 절개술을 이용한 간외담관결석 제거 후 결석 재발에 영향을 미치는 인자

Abstract

Background/Aims: Long term results of an endoscopic sphincterotomy (EST) have still been poorly estimated. The aim of this study was to assess late complications of EST. Methods: The rate of late complications were retrospectively evaluated in with 91 patients (mean age, 59.1 years; range, 28∼86 years; M：F, 44：47), who underwent EST for choledocholithiasis. Results: Forty six patients (50.5%) had their gallbladder in situ, and 45 patients (49.5%) underwent cholecystectomy. Early complications (＜30 days) such as hemorrhage, pancreatitis, and perforation occurred in 7 patients (7.7%). During a mean period of 53.4 months (range, 24∼134 months), 26 patients (28.0%) developed late complications, including a recurrence of CBD stones in 20 patients (22.0%) (8-gallbladder in situ, 12-cholecystectomized). An univariate analysis of risk factors for stone recurrence revealed dilated ducts, stone sizes, and stone numbers which were not related with stone recurrence. The history of choledocholithotomy with cholecystectomy was significantly related to stone recurrence. Conclusions: After EST for bile duct stones, late complications occurred in a significant proportion of patients and it was determined that a history of choledocholithotomy with cholecystectomy was significantly correlated with stone recurrence.