Ductal stones recurrence after extracorporeal shock wave lithotripsy for difficult common bile duct stones: Predictive factors

作者：Muratori Rosangela; Mandolesi Daniele^*; Pierantoni Chiara; Festi Davide; Colecchia Antonio; Mazzella Giuseppe; Bazzoli Franco; Azzaroli Francesco

来源：Digestive and Liver Disease, 2017, 49(10): 1128-1132.

DOI：10.1016/j.dld.2017.05.010

• Bile duct stone recurrence
• Cholelithiasis
• Extracorporeal shock wave lithotripsy
• Ursodeoxycholic acid

Background & purpose: Extra-corporeal shock wave lithotripsy (ESWL) can be considered in difficult common bile duct stones (DCBDS), with a success rate greater than 90% but data on stone recurrence after ESWL are limited. We performed a retrospective analysis to evaluate long-term outcomes in patients who underwent ESWL for DCBDS.
Methods: From May 1992 to October 2012, patients who underwent ESWL treatment for DCBDS, not amenable to endoscopic extraction, were included. Data on long-term outcome were collected through phone interviews and medical records.
Results: A total of 201 patients with a successful clearance of DCBDS after ESWL were included. During a median follow-up period of 4.64 years, 40 patients (20%) developed a recurrence of bile duct stones. Logistic regression analysis showed that the common bile duct diameter, gallstones presence and the maximum stone size were significantly associated with recurrence.
Conclusions: We observed a recurrence rate of 20% over a median follow-up of 4 years. Gallbladder stones, stone size and a dilated common bile duct diameter are risk factors for recurrent stone formation, while ursodeoxycholic acid treatment did not influence recurrence in our population.

• 出版日期2017-10