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Assessment of postoperative common bile duct stones after endoscopic extraction and subsequent cholecystectomy

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Title: Assessment of postoperative common bile duct stones after endoscopic extraction and subsequent cholecystectomy
Authors: Sugiura, Ryo Browse this author
Nakamura, Hideaki Browse this author
Horita, Shoichi Browse this author
Meguro, Takashi Browse this author
Sasaki, Kiyotaka Browse this author
Kagaya, Hidetoshi Browse this author
Yoshida, Tatsuya Browse this author
Aoki, Hironori Browse this author
Morita, Takayuki Browse this author
Fujita, Miyoshi Browse this author
Tamoto, Eiji Browse this author
Fukushima, Masayuki Browse this author
Ashitate, Yoshitomo Browse this author
Ueno, Takashi Browse this author
Tsutaho, Akio Browse this author
Kuwatani, Masaki Browse this author →KAKEN DB
Sakamoto, Naoya Browse this author →KAKEN DB
Keywords: Cholecystectomy
Common bile duct stone
Cystic duct stone
Endoscopic stone extraction
Gallbladder stone
Postoperative common bile duct stone
Issue Date: 1-Sep-2022
Publisher: Springer
Journal Title: Surgical endoscopy and other interventional techniques
Volume: 36
Issue: 9
Start Page: 6535
End Page: 6542
Publisher DOI: 10.1007/s00464-022-09017-z
Abstract: Background Common bile duct stones (CBDSs) occasionally cause serious diseases, and endoscopic extraction is the standard procedure for CBDS. To prevent biliary complications, cholecystectomy is recommended for patients who present with gallbladder (GB) stones after endoscopic CBDS extraction. However, CBDS can occasionally recur. To date, the occurrence of CBDS after endoscopic CBDS extraction and subsequent cholecystectomy is not fully understood. Hence, the current study aimed to evaluate the incidence of postoperative CBDSs. Methods This retrospective observational study included consecutive patients who underwent postoperative endoscopic retrograde cholangiography after endoscopic CBDS extraction and subsequent cholecystectomy between April 2012 and June 2021 at our institution. After endoscopic CBDS extraction, a biliary plastic stent was inserted to prevent obstructive cholangitis. Endoscopic retrograde cholangiography was performed to evaluate postoperative CBDSs after cholecystectomy until hospital discharge. The outcomes were the incidence of postoperative CBDSs and CBDSs/sludge. Moreover, the predictive factors for postoperative CBDSs were evaluated via univariate and multivariate analyses. Results Of eligible 204 patients, 52 patients (25.5%) presented with postoperative CBDSs. The incidence rate of CBDS/sludge was 36.8% (n = 75). Based on the univariate analysis, the significant predictive factors for postoperative CBDSs were >= 6 CBDSs, presence of cystic duct stones, and >= 10 GB stones (P < 0.05). Moreover, male sex and < 60-mm minor axis in GB might be predictive factors (P < 0.10). Based on the multivariate analysis, >= 6 CBDSs (odds ratio = 6.65, P < 0.01), presence of cystic duct stones (odds ratio = 4.39, P < 0.01), and >= 10 GB stones (odds ratio = 2.55, P = 0.01) were independent predictive factors for postoperative CBDSs. Conclusions The incidence of postoperative CBDS was relatively high. Hence, patients with predictive factors for postoperative CBDS must undergo imaging tests or additional endoscopic procedure after cholecystectomy.
Rights: This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at:
Type: article (author version)
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 杉浦 諒

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