Preventive Saline Irrigation of the Bile Duct After the Endoscopic Removal of Common Bile Duct Stones |
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Authors: | Sang Eon Jang Dong-Won Ahn Sang Hyub Lee Ban Seok Lee Ji Bong Jeong Jin-Hyeok Hwang Ji Kon Ryu Yong-Tae Kim Kyoung Ho Lee Young Hoon Kim |
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Institution: | 1. Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea 3. Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoungnam-si, Gyeonggi-do, Korea 4. Department of Internal Medicine, Cheongju St. Mary’s Hospital, Cheongju, Korea 5. Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea 2. Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea 6. Department of Internal Medicine, Cheju Halla General Hospital, Jeju, Korea 7. Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoungnam-si, Gyeonggi-do, Korea
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Abstract: | Background Small stone fragments after an endoscopic stone extraction for choledocholithiasis may act as the nidus for recurrent choledocholithiasis. Therefore, efforts to eliminate the nidus might reduce the recurrence of choledocholithiasis and cholangitis related to choledocholithiasis. Aims The purpose of this study was to determine whether an additional preventive saline irrigation of the bile duct after the endoscopic removal of common bile duct stones would decrease residual stones and the recurrence of cholangitis. Methods A retrospective analysis was performed for the consecutively collected data about the patients who underwent the complete endoscopic treatment for common bile duct stone. Results Among 99 patients, 45 patients underwent saline irrigation. Residual stones were detected in 18 patients (18.2 %). The incidences of residual stones were 8.9 % (4 of 45 patients) in the irrigation group and 25.9 % (14 of 54 patients) in the non-irrigation group (P = 0.037). In multivariate analysis, preventive saline irrigation was found to be the only significant factor for the decrease of residual stones (HR = 0.258, P = 0.039). When analyzing the occurrence of recurrent cholangitis and the procedure related to complications, there were no significant differences according to the performance of preventive saline irrigation of the bile duct. Conclusions Preventive saline irrigation could reduce the residual common bile duct stones without complications. |
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