Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Mar 27, 2022; 14(3): 236-246
Published online Mar 27, 2022. doi: 10.4240/wjgs.v14.i3.236
New common bile duct morphological subtypes: Risk predictors of common bile duct stone recurrence
Xu Ji, Zhuo Yang, Shu-Ren Ma, Wen Jia, Qian Zhao, Lu Xu, Ying Kan, Yang Cao, Yao Wang, Bao-Jun Fan
Xu Ji, Zhuo Yang, Shu-Ren Ma, Wen Jia, Qian Zhao, Lu Xu, Ying Kan, Yang Cao, Yao Wang, Bao-Jun Fan, Department of Digestive Endoscopy, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China
Xu Ji, Postgraduate College, Dalian Medical University, Dalian 116044, Liaoning Province, China
Author contributions: Ji X and Yang Z contributed to drafting the final manuscript; Ji X, Ma SR, Jia W, Zhao Q, Xu L, Ka Y, Cao Y, Wang Y, Fan BJ, Yang Z contributed to study design, data collection, statistical analysis, and reading and approving the final manuscript.
Supported by Key Research and Development Program of Liaoning Province, China, No. 2019JH2/10300026.
Institutional review board statement: The study was reviewed and approved by the General Hospital of Northern Theater Command Institutional Review Board [No. Y(2021)067].
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors disclose no conflicts.
Data sharing statement: No additional data are available.
Open-Access: 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/
Corresponding author: Zhuo Yang, MD, Chief Doctor, Department of Digestive Endoscopy, General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenyang 110840, Liaoning Province, China. yangzhuocy@163.com
Received: November 1, 2021
Peer-review started: November 1, 2021
First decision: December 4, 2021
Revised: December 12, 2021
Accepted: March 6, 2022
Article in press: March 6, 2022
Published online: March 27, 2022
ARTICLE HIGHLIGHTS
Research background

Preventing recurrent common bile duct (CBD) stones is an indispensable study. However, the risk factors for CBD stone recurrence after Endoscopic retrograde cholangiopancreatography (ERCP) are unclear.

Research motivation

The CBD on the cholangiogram is common in every ERCP operations. But CBD morphology has never been classified and discussed.

Research objectives

The aim was to investigate the relationship between CBD morphology and recurrent CBD stones in patients after ERCP.

Research methods

From February 2020 to January 2021, 502 patients after ERCP at our center were included in the retrospective case-control study. Univariate analysis and multivariate logistic regression analysis were performed to identify risk factors for CBD stone recurrence.

Research results

CBD morphology, CBD diameter ≥ 1.5 cm, and endoscopic biliary sphincterotomy with balloon dilation (ESBD) are three independent risk factors for CBD stone recurrence. Furthermore, CBD diameter ≥ 1.5 cm could increase the risk of recurrence and ESBD could decrease the risk of recurrence.

Research conclusions

Of the three CBD morphology, patients with the S type had the highest risk of recurrent CBD stones, followed by those with the polyline type and the lowest were the straight type.

Research perspectives

A large-scale prospective study should be performed to verified patients with above risk factors could prevent recurrence with medical treatment, such as Ursodeoxycholic acid. And the surveillance period needs further research.