Short-term Clinical Outcomes Based on Risk Factors of Recurrence after Removing Common Bile Duct Stones with Endoscopic Papillary Large Balloon Dilatation
김정호, 김연석, 김동규, 하민수, 이영준, 이종준, 이상진, 원인식, 구양서, 김연수, 김주현,
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김정호 ( Kim Jung-Ho )
가천의과학대학교 길병원 내과학교실
김연석 ( Kim Yeon-Suk )
가천의과학대학교 길병원 내과학교실
김동규 ( Kim Dong-Kyu )
가천의과학대학교 길병원 내과학교실
하민수 ( Ha Min-Su )
가천의과학대학교 길병원 내과학교실
이영준 ( Lee Young-Jun )
가천의과학대학교 길병원 내과학교실
이종준 ( Lee Jong-Joon )
가천의과학대학교 길병원 내과학교실
이상진 ( Lee Sang-Jin )
가천의과학대학교 길병원 내과학교실
원인식 ( Won In-Sik )
가천의과학대학교 길병원 내과학교실
구양서 ( Koo Yang-Suh )
가천의과학대학교 길병원 내과학교실
김연수 ( Kim Yun-Soo )
가천의과학대학교 길병원 내과학교실
김주현 ( Kim Ju-Hyun )
가천의과학대학교 길병원 내과학교실
KMID : 0359020110440020123
Abstract
Background/Aims: Recurrence is an important late complication of endotherapy of bile duct stones. Endoscopic papillary large balloon dilation (EPLBD) can be used as an alternative method of removing difficult bile duct stones. The aim of this study was to evaluate short term clinical outcomes after removing common bile duct (CBD) stones using EPLBD.
Methods: A retrospective review was performed based on the medical records of 141 patients who received EPLBD, with or without endoscopic sphincterotomy, between September 2008 and February 2010. Of these, 50 patients, were enrolled in the study. Clinical and endoscopic parameters were analyzed to identify risk factors for CBD stones recurrence.
Results: Male:Female ratio was 22:28 (mean age, 67.4±14.4 years). Recurrence rate was 24.0% (12/50). Mean follow-up period was 10.8± 4.5 months. Nineteen (38.0%) had a history of surgery and 20 (40.0%) were comorbid with periampullary diverticula. Mean diameters of the stones and CBD were 13.8±4.3 mm and 20.1±7.2 mm, respectively. In univariate analysis, large CBD stones (≥12 mm) and angulated CBD (angle ≤145°) were identified as the significant predictors of recurrence. In multivariate analysis, angulated CBD (angle ≤145°) was the significant independent risk factor for recurrence.
Conclusion: Close follow-up seems necessary in patients with angulated CBD (angle ≤145°).
키워드
Endoscopic papillary large balloon dilatation; Common bile duct stones; Recurrence; Risk factors
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