Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jan 16, 2017; 9(1): 26-33
Published online Jan 16, 2017. doi: 10.4253/wjge.v9.i1.26
Recurrence of choledocholithiasis following endoscopic bile duct clearance: Long term results and factors associated with recurrent bile duct stones
Christos Konstantakis, Christos Triantos, Vasileios Theopistos, Georgios Theocharis, Ioannis Maroulis, Georgia Diamantopoulou, Konstantinos Thomopoulos
Christos Konstantakis, Department of Gastroenterology, General Hospital of Patras, 26335 Patras, Greece
Christos Konstantakis, Christos Triantos, Vasileios Theopistos, Georgios Theocharis, Ioannis Maroulis, Georgia Diamantopoulou, Konstantinos Thomopoulos, Department of Gastroenterology, University Hospital of Patras, 26504 Patras, Greece
Author contributions: Konstantakis C and Thomopoulos K contributed equally to this work; Konstantakis C collected and analyzed the data, and drafted the manuscript; Thomopoulos K provided analytical oversight; Thomopoulos K designed and supervised the study; Triantos C, Theopistos V, Theocharis G and Maroulis I revised the manuscript for important intellectual content; Triantos C and Thomopoulos K offered technical or material support; Triantos C and Diamantopoulou G provided administrative support; all authors have read and approved the final version to be published.
Institutional review board statement: The study was reviewed and approved by the Ethics committee of the University Hospital of Patras.
Informed consent statement: All study participants, or their legal guardian, provided written or verbal informed consent prior to study enrollment.
Conflict-of-interest statement: The Authors have nothing to declare.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at asraiah@yahoo.com.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Christos Konstantakis, MD, Department of Gastroenterology, General Hospital of Patras, 1 Tsertidou St, 26335 Patras, Greece. asraiah@yahoo.com
Telephone: +30-6974-563157 Fax: +30-2613-601893
Received: June 29, 2016
Peer-review started: July 1, 2016
First decision: August 22, 2016
Revised: September 17, 2016
Accepted: October 17, 2016
Article in press: October 19, 2016
Published online: January 16, 2017
Core Tip

Core tip: Recurrence of choledocholithiasis is considered a late complication following endoscopic extraction of bile duct stones. There are various factors associated with the risk of recurrence. In our study the rate of recurrence was 13.5%. Although univariate analysis identified four different risk factors associated with both anatomical parameters (common bile duct diameter) and stone characteristics (stone size, use of mechanical lithotripsy, difficult lithiasis), multivariate analysis confirmed only bile duct diameter as being important. The underlying pathogenetic mechanism of recurrence is likely multifactorial in nature. Bile stasis, duodenal - biliary reflux and unfavorable stone characteristics probably contribute towards stone reformation.