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Low insertion of cystic duct increases risk for common bile duct stone recurrence

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A Correction to this article was published on 22 July 2021

This article has been updated

Abstract

Background

Common bile duct (CBD) stone is one of the most frequent biliary diseases. Recurrence after the complete removal of CBD stones is high, and we aim to evaluate the rate and risk factors for symptomatic recurrence of CBD stones after endoscopic retrograde cholangiopancreatography (ERCP).

Methods

We, retrospectively, reviewed the database of patients who underwent ERCP for CBD stones and subsequent cholecystectomy between January 2015 and December 2017 at a tertiary hospital. The recurrence of symptomatic CBD stones was defined as the presence of a CBD stone with related symptoms at least 6 months after the ERCP procedure. The primary outcomes were recurrence of symptomatic CBD stones and its risk factors.

Results

Among the 362 enrolled patients, 60 experienced a symptomatic recurrence of CBD stones between 6 months and 5 years after the procedure. The mean duration of follow-up was 32.3 ± 8.1 months. The patients with recurrences were older and had a longer follow-up duration. Low insertion of the cystic duct (HR = 2.893, p = 0.016), distal CBD angulation (HR = 1.015, p = 0.034), maximum CBD diameter (HR = 1.070, p = 0.012), number of ERCP sessions at first admission (HR = 1.558, p = 0.032), and cannulation time (HR = 1.030, p = 0.008) were the independent risk factors for symptomatic recurrent CBD stones.

Conclusions

Patients with risk factors, especially those with low cystic duct insertion, are more prone to symptomatic recurrent CBD stones and should be followed more carefully.

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Change history

  • 22 June 2021

    This article was updated to correct author name Jai Hoon Yoon (first name: Jai Hoon, family name: Yoon).

  • 22 July 2021

    A Correction to this paper has been published: https://doi.org/10.1007/s00464-021-08623-7

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Acknowledgements

This work was supported by the National Research Foundation of Korea(NRF) grant funded by the Korea government(MSIT) (NRF-2021M3E5D1A01015177), and by the research fund of Hanyang University (HY- 2018).

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Authors and Affiliations

  1. Department of Internal Medicine, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea

    Seong Ji Choi, Jai Hoon Yoon, Hang Lak Lee, Dae Won Jun & Ho Soon Choi

  2. Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, 18450, Republic of Korea

    Dong Hee Koh

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  1. Seong Ji Choi
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Correspondence to Jai Hoon Yoon.

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Seong Ji Choi, Yoon Jai Hoon, Dong Hee Koh, Hang Lak Lee, Dae Won Jun, and Ho Soon Choi have no conflicts of interest or financial ties to disclose.

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The study was conducted in accordance with the Helsinki Declaration and was approved by the Hanyang University Hospital Institutional Review Board (HYUH 2020-03-017-001).

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Choi, S.J., Yoon, J.H., Koh, D.H. et al. Low insertion of cystic duct increases risk for common bile duct stone recurrence. Surg Endosc 36, 2786–2792 (2022). https://doi.org/10.1007/s00464-021-08563-2

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