Analysis Of Risk Factors Of Recurrence Of Common Bile Duct Stones After Endoscopic Retrograde Cholangiopancreatography

Objective:To investigate the related risk factors of recurrent common bile duct(CBD)stones after endoscopic retrograde cholangiopancreatography,then provide a reference for clinical mornitoring.Methods:A retrospective analysis was made of 406 patients with choledocholithiasis underwent small endoscopic sphincterotomy combined with endoscopic papillary balloon dilation from January 2017 to April 2020.According to the recurrence of CBDS,the patients were divided into a recurrence group and a non-recurrence group,and a multivariate analysis was performed to determine the factors that might influence recurrence of choledocholithiasis.Results:1.A total of 966 patients were followed up with a mean duration of 37.35 months,with140 patients in recurrent group,the recurrence rate is 14.49%.2.Diabetes,elevated serum thyrotropin levels(overt hypothyroidism and subclinical hypothyroidism),age,initial course of disease,Alanine aminotransferase(ALT),biliary duct infection,history of cholecystectomy,diameter of CBD,multiple choledocholithiasis(≥2),the diameter of choledocholithiasis ≥12mm,muddy stone,mechanical lithotripsy under endoscope(EML),and CBD stent implantation were risk factors for recurrence of choledocholithiasis after ERCP(P < 0.05).3.History of smoking,alcohol consumption,hypertension,sex,aspartate aminotransferase(AST),glutamyl transpeptidase(GGT),alkaline phosphatase(ALP),total bilirubin(TBil),direct bilirubin(DBil),hyperlipidemia,diverticula,history of biliary surgery,biliary strictures,secondary lithotomy,and early postoperative complications(bleeding,postoperative perforation,infection,acute pancreatitis)are not risk factors for recurrence of common bile duct stones after ERCP lithotomy(P>0.05).4.Multivariate analysis showed that diabetes,age≥65,initial course of disease>3d,biliary duct infection,history of cholecystectomy and multiple choledocholithiasis(≥2)were the independent risk factors for recurrence of choledocholithiasis after ERCP(P<0.05).Conclusions:This study confirmed that diabetes,age ≥65,initial course of disease>3d,biliary duct infection,history of choledochotomy and multiple choledocholithiasis(≥2)were independent risk factors for recurrence of CBDS after ERCP.