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Long-term follow-up study of gallbladder in situ after endoscopic common duct stone removal in Korean patients

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Abstract

Background

Although there has been much debate over the fate of the gallbladder (GB) after endoscopic common bile duct (CBD) stone removal, subsequent cholecystectomy is generally recommended in patients with GB stones to prevent further biliary complications. The aims of this study were to assess the natural course of the patients with GB in situ after endoscopic CBD stone removal and to evaluate the necessity of prophylactic cholecystectomy.

Methods

Four hundred sixty-one patients who had undergone CBD stone removal at Yeungnam University Hospital between January 2000 and December 2004 were retrospectively analyzed, and 232 patients were ultimately enrolled in this study.

Results

The mean duration of follow-up was 73 (range = 7–126) months in the cholecystectomy group and 66 (6–127) months in the GB in situ group (p = 0.168). Ten patients (14.7 %) in the cholecystectomy group and 31 patients (18.9 %) in the GB in situ group developed recurrent CBD stones (p = 0.295). The highest percentage of recurrent CBD stones in both groups was that for brown stones (80 and 80.6 %). In the GB in situ group, cumulative recurrence rates of CBD stones were not significantly different between patients with GB stones and without GB stones (15.9 vs. 20 %, p = 0.798). However, the incidence of acute cholecystitis was significantly higher in patients with GB stones compared to patients without GB stones (13.6 vs. 2.5 %, p = 0.003).

Conclusions

Prophylactic cholecystectomy seems to be unnecessary in patients without GB stones after endoscopic sphincterotomy. However, in patients with GB stones, elective cholecystectomy or close observation is recommended due to the higher risk of cholecystitis.

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References

  1. Classen M, Demling L (1974) Endoscopic sphincterotomy of the papilla of vater and extraction of stones from the choledochal duct (author’s transl). Dtsch Med Wochenschr 99:496–497

    Article  PubMed  CAS  Google Scholar 

  2. Kawai K, Akasaka Y, Murakami K, Tada M, Koli Y (1974) Endoscopic sphincterotomy of the ampulla of Vater. Gastrointest Endosc 20:148–151

    Article  PubMed  CAS  Google Scholar 

  3. Boerma D, Rauws EA, Keulemans YC, Janssen IM, Bolwerk CJ, Timmer R, Boerma EJ, Obertop H, Huibregtse K, Gouma DJ (2002) Wait-and-see policy or laparoscopic cholecystectomy after endoscopic sphincterotomy for bile-duct stones: a randomised trial. Lancet 360:761–765

    Article  PubMed  Google Scholar 

  4. Lai KH, Lin LF, Lo GH, Cheng JS, Huang RL, Lin CK, Huang JS, Hsu PI, Peng NJ, Ger LP (1999) Does cholecystectomy after endoscopic sphincterotomy prevent the recurrence of biliary complications? Gastrointest Endosc 49:483–487

    Article  PubMed  CAS  Google Scholar 

  5. Hill J, Martin DF, Tweedle DE (1991) Risks of leaving the gallbladder in situ after endoscopic sphincterotomy for bile duct stones. Br J Surg 78:554–557

    Article  PubMed  CAS  Google Scholar 

  6. Kullman E, Borch K, Dahlin LG, Liedberg G (1991) Long-term follow-up of patients with gallbladder in situ after endoscopic sphincterotomy for choledocholithiasis. Eur J Surg 157:131–135

    PubMed  CAS  Google Scholar 

  7. Kwon SK, Lee BS, Kim NJ, Lee HY, Chae HB, Youn SJ, Park SM (2001) Is cholecystectomy necessary after ERCP for bile duct stones in patients with gallbladder in situ? Korean J Intern Med 16:254–259

    PubMed  CAS  Google Scholar 

  8. Hammarstrom LE, Holmin T, Stridbeck H (1996) Endoscopic treatment of bile duct calculi in patients with gallbladder in situ: long-term outcome and factors. Scand J Gastroenterol 31:294–301

    Article  PubMed  CAS  Google Scholar 

  9. Neoptolemos JP, Carr-Locke DL, Fraser I, Fossard DP (1984) The management of common bile duct calculi by endoscopic sphincterotomy in patients with gallbladders in situ. Br J Surg 71:69–71

    Article  PubMed  CAS  Google Scholar 

  10. Welbourn CR, Beckly DE, Eyre-Brook IA (1995) Endoscopic sphincterotomy without cholecystectomy for gall stone pancreatitis. Gut 37:119–120

    Article  PubMed  CAS  Google Scholar 

  11. Archibald JD, Love JR, McAlister VC (2007) The role of prophylactic cholecystectomy versus deferral in the care of patients after endoscopic sphincterotomy. Can J Surg 50:19–23

    PubMed  Google Scholar 

  12. Kang EH, Na YS, Lee SH, Choi TY, Shin WC, Lee JH, Choi WC, Kim KY (2000) Endoscopic treatment of bile duct calculi in patients with gallbladder in situ. Korean J Gastrointest Endosc 20:21–25

    Google Scholar 

  13. Kang JK, Park IS, Chung JB, Moon YM, Kim HG, Song SY, Lee JH, Cheong JY, Jung BG (1999) Factor influencing the recurrence of CBD stones after an endoscopic sphincteromy. Korean J Gastrointest Endosc 19:581–587

    Google Scholar 

  14. Park CW, Kim JH, Lee DJ, Kim KY, Suh JI, Kim TN, Chung MK (1997) A study of necessity for cholecystectomy after endoscopic common bile duct stone removal. Korean J Gastroenterol 29:659–666

    Google Scholar 

  15. Kim MH, Lim BC, Myung SJ, Lee SK, Ohrr HC, Kim YT, Roe IH, Kim JH, Chung JB, Kim CD, Shim CS, Yun YB, Min YI, Yang US, Kang JK (1999) Epidemiological study on Korean gallstone disease: a nationwide cooperative study. Dig Dis Sci 44:1674–1683

    Article  PubMed  CAS  Google Scholar 

  16. Yasui T, Takahata S, Kono H, Nagayoshi Y, Mori Y, Tsutsumi K, Sadakari Y, Ohtsuka T, Nakamura M, Tanaka M (2012) Is cholecystectomy necessary after endoscopic treatment of bile duct stones in patients older than 80 years of age? J Gastroenterol 47:65–70

    Article  PubMed  Google Scholar 

  17. Tanaka M, Takahata S, Konomi H, Matsunaga H, Yokohata K, Takeda T, Utsunomiya N, Ikeda S (1998) Long-term consequence of endoscopic sphincterotomy for bile duct stones. Gastrointest Endosc 48:465–469

    Article  PubMed  CAS  Google Scholar 

  18. Yi SY (2000) Recurrence of biliary symptoms after endoscopic sphincterotomy for choledocholithiasis in patients with gall bladder stones. J Gastroenterol Hepatol 15:661–664

    Article  PubMed  CAS  Google Scholar 

  19. Kageoka M, Watanabe F, Maruyama Y, Nagata K, Ohata A, Noda Y, Miwa I, Ikeya K (2009) Long-term prognosis of patients after endoscopic sphincterotomy for choledocholithiasis. Dig Endosc 21:170–175

    Article  PubMed  Google Scholar 

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Disclosures

Drs. Mei Lan Cui, Joon Hyun Cho, and Tae Nyeun Kim have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung 5-dong, Nam-gu, Daegu, 705-717, Korea

    Mei Lan Cui, Joon Hyun Cho & Tae Nyeun Kim

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  1. Mei Lan Cui
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  2. Joon Hyun Cho
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  3. Tae Nyeun Kim
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Correspondence to Tae Nyeun Kim.

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Cui, M.L., Cho, J.H. & Kim, T.N. Long-term follow-up study of gallbladder in situ after endoscopic common duct stone removal in Korean patients. Surg Endosc 27, 1711–1716 (2013). https://doi.org/10.1007/s00464-012-2662-0

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  • DOI: https://doi.org/10.1007/s00464-012-2662-0

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