Background

Recurrent common bile duct (CBD) stone is a long-term sequalae among patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) with CBD stone extraction. Data regarding risk factors for recurrent CBD stone are scarce. We aimed to identify predictors of recurrent CBD stone.

Methods

We performed a retrospective case-controlled study from January 2010 to December 2019. Inclusion criteria included patients who had recurrent CBD stone at least 6 months after the index ERCP, in which complete stone extraction was performed and normal cholangiogram was obtained. Overall, 457 patients were included. Forty-two patients (9.2%) had recurrent CBD stone, and 415 patients (90.8%) did not have recurrent CBD stone.

Results

In univariate analysis, male sex [odds ratio (OR) = 0.49, P = 0.033] was a protective factor, while endoscopic stone extraction by basket vs. balloon (OR = 2.55, P = 0.005), older age (OR = 1.03, P = 0.003), number of CBD stones (OR = 1.99, P = 0.037), size of CBD stone (OR = 4.06, P = 0.003) and mechanical lithotripsy (OR = 9.22, P = 0.004) were risk factors for recurrent CBD stone. In multivariate logistic regression analysis, mechanical lithotripsy [OR = 9.73, 95% confidence interval (CI): 1.69–55.89, P = 0.010], basket clearance vs. combined basket and balloon (OR = 18.25, 95% CI: 1.05–318.35, P = 0.046) and older age (OR = 1.02, 95% CI: 1.00–1.05, P = 0.023) were risk factors, and male sex (OR = 0.39, 95% CI: 0.19–0.81, P = 0.012) was a protective factor.

Conclusions

We identified modifiable and non-modifiable risk factors for recurrent CBD stone. Taking into consideration those factors might aid in minimizing the CBD stone recurrence risk.

中文翻译：

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内镜逆行胰胆管造影清除后胆管结石复发的预测因素：病例对照研究

背景

复发性胆总管 (CBD) 结石是接受内镜逆行胰胆管造影 (ERCP) 和 CBD 结石提取的患者的长期后遗症。关于复发性 CBD 结石风险因素的数据很少。我们旨在确定复发性 CBD 结石的预测因子。

方法

我们在 2010 年 1 月至 2019 年 12 月期间进行了一项回顾性病例对照研究。纳入标准包括在 ERCP 指数后至少 6 个月复发 CBD 结石的患者，其中进行了完整的结石提取并获得了正常的胆管造影。总共包括 457 名患者。42 名患者 (9.2%) 有复发性 CBD 结石，415 名患者 (90.8%) 没有复发性 CBD 结石。

结果

在单变量分析中，男性 [优势比 (OR) = 0.49, P  = 0.033] 是一个保护因素，而内镜下篮取石与球囊取石 (OR = 2.55, P  = 0.005)、年龄较大 (OR = 1.03, P  = 0.003)、CBD 结石数量 (OR = 1.99, P  = 0.037)、CBD 结石大小 (OR = 4.06, P  = 0.003) 和机械碎石术 (OR = 9.22, P  = 0.004) 是复发 CBD 的危险因素石头。在多变量逻辑回归分析中，机械碎石术 [OR = 9.73, 95% 置信区间 (CI): 1.69–55.89, P  = 0.010]，篮子清除率与篮子和球囊组合 (OR = 18.25, 95% CI: 1.05–318.35 ,磷 = 0.046) 和年龄较大 (OR = 1.02, 95% CI: 1.00–1.05, P  = 0.023) 是危险因素，男性 (OR = 0.39, 95% CI: 0.19–0.81, P  = 0.012) 是保护性因素因素。

结论

我们确定了复发性 CBD 结石的可改变和不可改变的风险因素。考虑到这些因素可能有助于最大限度地降低 CBD 结石复发的风险。