INCIDENCE OF REMNANT CBD STONES IN PATIENTS UNDERWENT CHOLECYSTECTOMY AFTER ENDOSCOPIC CHOLEDOCHOLITHIASIS EXTRACTION FOR CHOLECYSTO-CHOLEDOCHOLITHIASIS

Aims:

Patients with cholecysto-choledocholithiasis undergo generally cholecystectomy after endoscopic choledocholithiasis extraction. Early recurrence of common bile duct (CBD) stone after cholecystectomy can occur due to migration of cholecystolithiasis into bile duct during operation or incomplete endoscopic removal of choledocholithiasis. The aim of this study was to investigate the incidence of remnant CBD stones after cholecystectomy.

Methods:

A total of 121 patients (mean age 59.9yrs, male 59 (48.8%)) who underwent endoscopic CBD stones removal followed by cholecystectomy from 2011 to 2015 were included. All patients had the placement of an endoscopic nasobiliary drainage (ENBD) tube from the time after endoscopic clearance of the CBD stones to the time after the cholecystectomy. ENBD tubogram was obtained in all patients to check the recurrence of CBD stone after operation.

Results:

Bile duct stones recurred in 19.0% (23/121). Post operation tubogram was done after average 2.42 days of post operation. Gender, age, urgency of procedure, type of sphincteroplasty and presence of periampullary diverticulum did not influence the recurrence rate. There were also no significant differences in the size, number, and kind of CBD stones or GB stones between the recurrence group and non-recurrence group. No independent risk factor was identified by multivariate analysis.

Conclusions:

Considering there is relatively high rate of remnant CBD stone after cholecystectomy, a routinely consecutive ERCP after cholecystectomy is needed in patient with cholecysto-choledocholithiasis.