The Risk Factors For Recurrence After Endoscopic Retrograde Cholangiopancreatography In The Treatment Of Choledocholithiasis

Background and Study Aims:The endoscopic retrograde cholangiopancreatography(ERCP) is widely used in the treatment of Bile Duct Stones,the late complication such as recurrence is growing year by year. In our study,the aim is to evaluate the risk factors for recurrence after ERCP,and provide theory evidence for preventing stone recurrence after ERCP in the future.Methods:A retrospective review was performed based on the 6221 patients who received ERCP and ensured the stones were all removed in our hospital between January 2007 and December 2014.281 patients with common bile duct stones recurrence were set as the experimental group,choosing 281 patients from the rest patients as the control group.The clinical data were investigated retrospectively,and risk factors for stone recurrence were univariately and multivariately analyzed.Results:Stone recurrence occurred in 281 patients(4.52%),the mean recurrence time is25.51 month. Univariate analysis suggested that cholecystolithiasis,endoscopic mechanical lithotripsy,Bile Duct with stents,endoscopic papillary balloon dilation,juxtapapillary duodenal diverticula,intrahepatic lithiasis,fistula between bile duct and duodenal,choledochotomy,bile duct diameter,the number of stone,stone size,ERCP times,age,bile duct angle are related to the recurrence of common bile duct stone.Multivariate analysis identified seven risk factors for stone recurrence:bile duct with stent(OR=3.311,95%CI:1.865-5.878,P=0.000),endoscopic papillary balloon dilation(OR=2.326,95%CI:1.312-4.123,P=0.004),juxtapapillary duodenal diverticula(OR=2.233,95%CI:1.451-3.367436,P=0.000),intrahepatic lithiasis(OR=3.008,95%CI:1.813-4.988,P=0.000),choledochotomy(OR=3.669,95%CI:2.035-6.618,P=0.000),ERCP times ≧ 2(OR=1.949,95%CI:1.263-3.008,P=0.003),age ≧50 years(OR=1.219,95%CI:1.036-1.435,P=0.017).Conclusion:Bile Duct with stent,endoscopic papillary balloon dilation, juxtapapillary duodenal diverticula,intrahepatic lithiasis,choledochotomy, ERCP times,age are the independent risk factors of common bile duct stones recurrence.