Study On Risk Factors Of Secondary Intrahepatic Bile Duct Stones After Choledocholithiasis Treated With ERCP

Objectiv:To investigate the risk factors of secondary intrahepatic bile duct stones after ERCP treatment of common bile duct stones.Methods:A total of 1533 patients treated with ERCP in the First Affiliated Hospital of Xinjiang Medical University from January 2015 to December 2019 were selected.Patients who were screened for secondary intrahepatic bile duct stones after ERCP were divided into control group and experimental group according to the inclusion and exclusion criteria.A total of 11 patients with secondary intrahepatic bile duct stones after surgery were selected as the experimental group,and 469 patients without secondary intrahepatic bile duct stones after surgery were selected as the control group,of which 44 cases were selected by simple random sampling method.In addition,univariate analysis was conducted for the risk factors of the two groups of patients,followed by multivariate Logistic regression analysis,and independent risk factors were finally summarized.Results:In this study,patients in the two groups had a history of cholecystectomy(X~2=4.341,P=0.037),maximum stone diameter≥10 mm(X~2=4.668,P=0.031),number of stones≥2(X~2=4.550,P=0.033),and common bile duct diameter≥15 mm(X~2=3.928,P=0.047).Biliary stent placement(X~2=5.893,P=0.015),and the difference was statistically significant.Logistic multivariate regression showed that the history of cholecystectomy,the number of stones≥2,the diameter of common bile duct≥15 mm,and the placement of biliary stent were independent risk factors for the formation of secondary bile duct stones.However,there was no significant difference in age,gender,history of underlying diseases(diabetes,hypertension,etc.)between the two groups.There was no significant difference in liver function and lipids.Conclusion:Secondary intrahepatic bile duct stones after the treatment of choledocholithiasis by ERCP are the result of multiple risk factors.When ERCP is applied in the treatment of choledocholithiasis,individualized treatment should be carried out according to the specific conditions of patients and relevant preventive measures should be strengthened to reduce the incidence of secondary intrahepatic bile duct stones.