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Predictors for stone recurrence after a successful common bile duct surgical exploration for choledocholithiasis

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Abstract

Background

Recurrence after common bile duct stone (CBDS) clearance is the major long-term drawback of their management. Its prevalence is significant, and it occurs after all primary therapeutic alternatives. The aim of this study was to determine the predictive factors associated with stone recurrence after surgical common bile duct exploration (CBDE).

Methods

A retrospective cohort study based on patients undergoing CBDE between 2000 and 2018 was conducted. Uni- and multivariate hierarchical regression analyses were performed to assess the independent predictive factors associated with recurrent CBDS in patients with initially successful surgery.

Results

A total of 365 patients underwent successful surgical procedures. After a median follow-up of 43.2 (IQR 84) months, 31 (8.4%) patients were diagnosed with CBD stone recurrence. The median time to recurrence was 30.3 (IQR 38) months. The only variable associated with CBDS recurrence was preoperative endoscopic sphincterotomy (HR 2.436, 95% CI: 1.031–5.751, P = 0.042)).

Conclusion

Patients who undergo preoperative endoscopic sphincterotomy and then cholecystectomy with successful common bile duct clearance may be at increased risk for recurrent stone disease compared to those who go straight to surgery.

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Authors and Affiliations

  1. Department of General and Digestive Surgery, Hospital Universitario Doctor Peset, Av/ Gaspar Aguilar 90, 46017, Valencia, Spain

    Paula Gonzálvez-Guardiola, Carmen Payá-Llorente, Carlos Domingo-del Pozo & Aleix Martínez-Pérez

  2. Faculty of Health Sciences, Valencian International University (VIU), C/ Pintor Sorolla 21, 46002, Valencia, Spain

    Aleix Martínez-Pérez

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  1. Paula Gonzálvez-Guardiola
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  2. Carmen Payá-Llorente
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  3. Carlos Domingo-del Pozo
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  4. Aleix Martínez-Pérez
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Correspondence to Aleix Martínez-Pérez.

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Gonzálvez-Guardiola, P., Payá-Llorente, C., Domingo-del Pozo, C. et al. Predictors for stone recurrence after a successful common bile duct surgical exploration for choledocholithiasis. Langenbecks Arch Surg 407, 1545–1552 (2022). https://doi.org/10.1007/s00423-022-02577-7

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