期刊
KOREAN JOURNAL OF INTERNAL MEDICINE
卷 36, 期 -, 页码 S27-S34出版社
KOREAN ASSOC INTERNAL MEDICINE
DOI: 10.3904/kjim.2020.060
关键词
Stents; Stone recurrence; Bile duct stone; Endoscopic retrograde cholangiopancreatography; Cholangitis
Biliary stenting after the removal of CBD stones reduces the stone recurrence rate and assists in recovery. Preventive biliary stent insertion can also reduce the rate of stone recurrence in patients with large and multiple stones undergoing lithotripsy.
Background/Aims: After endoscopic treatment of common bile duct (CBD) stones, recurrence of choledocholithiasis due to small stone fragments and post-endoscopic retrograde cholangiopancreatography (post-ERCP) cholangitis can occur. We determined the effect of biliary stenting after removal of CBD stones on the recurrence of CBD stones and the incidence of post-ERCP cholangitis. Methods: We performed a retrospective single-center study involving 483 patients who underwent ERCP for the removal of CBD stones. The patients were classified into two groups according to their biliary stenting status. The primary outcome was the rate of CBD stone recurrence and the secondary outcome was the incidence of post-ERCP cholangitis. Results: Among the 483 patients, 219 and 264 did and did not receive a biliary stent after CBD stone removal, respectively. The incidence of stone recurrence was 15.5% and 7.6% in the non-stenting and stenting groups (p = 0.006), respectively, while the incidence of post-ERCP cholangitis was 4.6% and 2.7% (p = 0.256). In a multivariate analysis, biliary stenting significantly reduced the stone recurrence rate (odds ratio, 0.30; p = 0.004). Conclusions: Biliary stenting after the removal of CBD stones reduces the stone recurrence rate and assisted recovery. For patients with large and multiple stones who undergo lithotripsy, preventive biliary stent insertion can reduce the rate of stone recurrence.
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