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Cholecystectomy for Prevention of Recurrence after Endoscopic Clearance of Bile Duct Stones in Korea

Authors
 Myung Eun Song  ;  Moon Jae Chung  ;  Dong-Jun Lee  ;  Tak Geun Oh  ;  Jeong Youp Park  ;  Seungmin Bang  ;  Seung Woo Park  ;  Si Young Song  ;  Jae Bock Chung 
Citation
 Yonsei Medical Journal, Vol.57(1) : 132-137, 2016 
Journal Title
 Yonsei Medical Journal 
ISSN
 0513-5796 
Issue Date
2016
MeSH
Adult ; Aged ; Bile Duct Diseases/diagnosis* ; Bile Duct Diseases/epidemiology ; Bile Duct Diseases/surgery ; Case-Control Studies ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy/methods* ; Common Bile Duct/diagnostic imaging ; Common Bile Duct/pathology* ; Elective Surgical Procedures ; Female ; Gallstones/epidemiology ; Gallstones/surgery* ; Humans ; Incidence ; Male ; Middle Aged ; Recurrence ; Republic of Korea/epidemiology ; Risk Factors ; Sphincterotomy, Endoscopic*
Keywords
Cholecystectomy ; common bile duct ; gallstones ; recurrence
Abstract
PURPOSE: Cholecystectomy in patients with an intact gallbladder after endoscopic removal of stones from the common bile duct (CBD) remains controversial. We conducted a case-control study to determine the risk of recurrent CBD stones and the benefit of cholecystectomy for prevention of recurrence after endoscopic removal of stones from the CBD in Korean patients. MATERIALS AND METHODS: A total of 317 patients who underwent endoscopic CBD stone extraction between 2006 and 2012 were included. Possible risk factors for the recurrence of CBD stones including previous cholecystectomy history, bile duct diameter, stone size, number of stones, stone composition, and the presence of a periampullary diverticulum were analyzed. RESULTS: The mean duration of follow-up after CBD stone extraction was 25.4±22.0 months. A CBD diameter of 15 mm or larger [odds ratio (OR), 1.930; 95% confidence interval (CI), 1.098 to 3.391; p=0.022] and the presence of a periampullary diverticulum (OR, 1.859; 95% CI, 1.014 to 3.408; p=0.045) were independent predictive factors for CBD stone recurrence. Seventeen patients (26.6%) in the recurrence group underwent elective cholecystectomy soon after endoscopic extraction of CBD stones, compared to 88 (34.8%) in the non-recurrence group; the difference was not statistically significant (p=0.212). CONCLUSION: A CBD diameter of 15 mm or larger and the presence of a periampullary diverticulum were found to be potential predictive factors for recurrence after endoscopic extraction of CBD stones. Elective cholecystectomy after clearance of CBD stones did not reduce the incidence of recurrent CBD stones in Korean patients.
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DOI
10.3349/ymj.2016.57.1.132
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
박승우(Park, Seung Woo) ORCID logo https://orcid.org/0000-0001-8230-964X
박정엽(Park, Jeong Youp) ORCID logo https://orcid.org/0000-0003-0110-8606
방승민(Bang, Seungmin) ORCID logo https://orcid.org/0000-0001-5209-8351
송명은(Song, Myung Eun)
송시영(Song, Si Young) ORCID logo https://orcid.org/0000-0002-1417-4314
오탁근(Oh, Tak Geun)
이동준(Lee, Dong Jun)
정문재(Chung, Moon Jae) ORCID logo https://orcid.org/0000-0002-5920-8549
정재복(Chung, Jae Bock)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146259
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