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©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
Causes associated with recurrent choledocholithiasis following therapeutic endoscopic retrograde cholangiopancreatography: A large sample sized retrospective study
Feng Deng, Mi Zhou, Ping-Ping Liu, Jun-Bo Hong, Guo-Hua Li, Xiao-Jiang Zhou, You-Xiang Chen
Feng Deng, The First Affiliated Hospital of Nanchang University, Nanchang 330000, Jiangxi Province, China
Mi Zhou, Medical College of Nanchang University, Nanchang 330000, Jiangxi Province, China
Ping-Ping Liu, Department of Gastroenterology, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou 341000, Jiangxi Province, China
Jun-Bo Hong, Guo-Hua Li, Xiao-Jiang Zhou, You-Xiang Chen, Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang 330000, Jiangxi Province, China
Author contributions: Deng F and Zhou M contributed equally to the study and share the primary authorship of this article; Deng F and Zhou M conceptualized and designed the study and wrote the manuscript; Liu PP collected the data; Hong JB made critical revisions to the manuscript; Li GH helped in interpreting and analyzing the data; Zhou XJ and Chen YX made substantial contributions to the conception, design, and coordination of the study and gave final approval of the version to be published; all authors read and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of the First Affiliated Hospital of Nanchang University.
Informed consent statement: All involved subjects gave their informed consent (written or verbal) prior to study inclusion.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
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/
Corresponding author: Xiao-Jiang Zhou, PhD, Associate Professor, Chief Doctor, Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, No. 17, Yongwaizheng Street, Nanchang 330000, Jiangxi Province, China. yfyzxj1970@163.com
Telephone: +86-791-88692540 Fax: +86-791-86292217
Received: February 16, 2019
Peer-review started: February 18, 2019
First decision: March 5, 2019
Revised: March 15, 2019
Accepted: March 26, 2019
Article in press: March 26, 2019
Published online: May 6, 2019
ARTICLE HIGHLIGHTS
Research background
Currently, endoscopic retrograde cholangiopancreatography (ERCP) technology is very advanced, but the recurrence of choledocholithiasis after ERCP is still a challenging problem. The potential causes of the recurrence of choledocholithiasis after ERCP are unclear.
Research motivation
To explore the independent risk factors for stone recurrence by comprehensively analyzing the relevant factors for stone recurrence in a large-sized sample.
Research objectives
The study aimed to analyze the potential causes of the recurrence of choledocholithiasis after ERCP.
Research methods
The ERCP database of our medical center was retrospectively reviewed, and information regarding eligible patients was collected. A 1:1 case-control study was used for this investigation. Data were analyzed by univariate and multivariate logistic regression and Kaplan-Meier analyses.
Research results
Multivariate logistic regression analysis showed that age > 65 years, combined history of choledocholithotomy, endoscopic papillary balloon dilation, endoscopic sphincterotomy, common bile duct stent implantation, multiple ERCP procedures (≥2), stones in the intrahepatic bile duct, periampullary diverticula, choledocholithiasis diameter ≥ 10 mm, bile duct-duodenal fistula, combined biliary tract infections, and no preoperative antibiotic use were independent risk factors for the recurrence of choledocholithiasis after ERCP.
Research conclusions
In this large sample sized retrospective study, we concluded that patient age greater than 65 years is an independent risk factor for the development of recurrent choledocholithiasis following ERCP, as is history of biliary surgeries, measures during ERCP, and prevention of postoperative complications.
Research perspectives
The pathogenesis of recurrence of choledocholithiasis should be studied in future, as well as the prevention and treatment.
