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Risk factors of recurrent choledocholithiasis following therapeutic endoscopic retrograde cholangiopancreatography
Authors:Li L  Wang J  Tong CC  He CY
Affiliation:Department of Gastroenterology, The First Affiliated Hospital of Wannan Medical College, Wuhu 241001, China;∗ Corresponding author.;E-mail address: hechiyi11@163.com (C.-Y. He).;# Contributed equally.
Abstract:Background: The risk factors for the recurrent choledocholithiasis after endoscopic retrograde cholangiopancreatography (ERCP) have not been well studied. The aim of this study was to explore the risk factors of recurrent choledocholithiasis.Methods: We carried out a retrospective analysis of data collected between January 1, 2010 and January 1, 2020. Univariate analysis and multivariate analysis were used to explore the independent risk factors of recurrent choledocholithiasis following therapeutic ERCP.Results: In total, 598 patients were eventually selected for analysis, 299 patients in the recurrent choledo- cholithiasis group and 299 patients in the control group. The overall rate of recurrent choledocholithiasis was 6.91%. Multivariate analysis showed that diabetes [odds ratio (OR) = 3.677, 95% confidence interval (CI): 1.875-7.209; P < 0.001], fatty liver (OR = 4.741, 95% CI: 1.205-18.653; P = 0.026), liver cirrhosis (OR = 3.900, 95% CI: 1.358-11.201; P = 0.011), history of smoking (OR = 3.773, 95% CI: 2.060- 6.908; P < 0.001), intrahepatic bile duct stone (OR = 4.208, 95% CI: 2.220-7.976; P < 0.001), biliary stent (OR = 2.996, 95% CI: 1.870-4.80 0; P < 0.0 01), and endoscopic papillary balloon dilation (EPBD) (OR = 3.009, 95% CI: 1.921-4.715; P < 0.001) were independent risk factors of recurrent choledocholithi- asis. However, history of drinking (OR = 0.183, 95% CI: 0.099-0.337; P < 0.001), eating light food fre- quently (OR = 0.511, 95% CI: 0.343-0.760; P = 0.001), and antibiotic use before ERCP (OR = 0.315, 95% CI: 0.200-0.497; P < 0.001) were independent protective factors of recurrent choledocholithiasis.Conclusions: Patients with the abovementioned risk factors are more likely to have recurrent CBD stones. Patients who eat light food frequently and have a history of drinking are less likely to present with recurrent CBD calculi.
Keywords:Recurrence  Choledocholithiasis  Endoscopic retrograde cholangiopancreatography  
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