잠시만 기다려 주세요. 로딩중입니다.

Risk factors of recurrence following common bile duct exploration for choledocholithiasis

Journal of Minimally Invasive Surgery 2021년 24권 1호 p.43 ~ 50
최현화, 민석기, 이현국, 이희성,
소속 상세정보
최현화 ( Choi Hyun-Hwa ) - Ewha Womans University Mokdong Hospital Department of Surgery
민석기 ( Min Seog-Ki ) - Hanyang University Seoul Hospital Department of Surgery
이현국 ( Lee Hyeon-Kook ) - Hanyang University Seoul Hospital Department of Surgery
이희성 ( Lee Hui-Song ) - Ewha Womans University Mokdong Hospital Department of Surgery

Abstract


Purpose: The purpose of this study was to investigate the recurrence factors of choledocholithiasis after common bile duct (CBD) exploration.

Methods: From January 2000 to December 2018, we retrospectively reviewed 253 patients who underwent CBD exploration surgery. We excluded 100 cases who had residual stone, combined major surgery, or follow-up loss after surgery. Total of 153 patients were included, and we investigated the recurrence factors of choledocholithiasis. Various variables such as patients’ demographics, gallstones, preoperative endoscopic treatment, and laboratory data were analyzed to find factors related to recurrent choledocholithiasis.

Results: The median follow-up period was 20.6 months (range 4.7?219 months), and 27 patients (17.6%) had experienced recurrent choledocholithiasis. Univariate analysis showed that the following variables were associated with recurrence of choledocholithiasis; preoperative leukocytosis (white blood cell ≥ 11,000/μL), open procedure, T tube insertion, long hospital duration, and long operation time. Logistic regression multivariate analysis identified preoperative leukocytosis (odds ratio [OR], 3.43; 95% confidence interval [CI], 1.21?9.73; p = 0.021), open procedure (OR, 5.54; 95% CI, 4.73?6.35; p = 0.037), and T-tube insertion (OR, 2.82; 95% CI, 1.04?7.65; p = 0.042) as independent predictors of recurrent choledocholithiasis.

Conclusion: Because of delayed recurrence of choledocholithiasis, it is recommended to continue follow-up of patients after CBD exploration surgery. Laparoscopic surgery was observed to be associated with a reduction in recurrence. The preoperative leukocytosis and clinical conditions in which open surgery is performed could be associated with recurrence of choledocholithiasis. However, further study is necessary to validate the result.

키워드

Common bile duct; Gall stones; Recurrence; Risk factors; Laparoscopic cholecystectomy

원문 및 링크아웃 정보

등재저널 정보