Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access
Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc
Journal website http://www.gastrores.org

Original Article

Volume 12, Number 4, August 2019, pages 191-197


Prophylactic Biliary Stenting Before Cholecystectomy in Patients With Gallstones and Common Bile Duct Stones

Figure

Figure 1.
Figure 1. A flow chart of the clinical strategy for the management of CBDS concomitant with GS in the present study. CBDS: common bile duct stones; GS: gallstones; ERC: endoscopic retrograde cholangiography; EST: endoscopic sphincterotomy; CT: computed tomography; MRCP: magnetic resonance cholangiopancreatography.

Tables

Table 1. Patient Characteristics According to the Change in the Number of CBDS Between First and Second ERC
 
Total (n = 39)
GS: gallstones; CBDS: common bile duct stones; ERC: endoscopic retrograde cholangiography.
Sex, n (%)
  Male20 (51)
  Female19 (49)
Median age (range)68 (40 - 89)
Maximal diameter of GS (mm)
  Median (range)7 (2 - 30)
Patients with multiple GS (≥ 5)21
Cholangitis on admission, n (%)
  Yes15 (38)
  No24 (62)
Maximal diameter of CBDS at first ERC (mm)
  Median (range)5 (0 - 11)
Patients with multiple CBDS (≥5)6
Minimal diameter of cystic duct
  Median (range)4 (1 - 8)
Residual CBDS at first ERC
  Yes5 (12)
  No34 (88)
Days between first ERC and operation
  Median (range)26 (2 - 131)
Laparoscopic cholecystectomy, n (%)
  Yes37 (95)
  No2 (5)
Operation time (min)
  Median (range)95 (48 - 260)
Days between operation and second ERC
  Median (range)41 (26 - 96)
Maximal diameter of CBDS at second ERC (mm)
  Median (range)0 (0 - 10)
Patients with multiple CBDS (≥ 5)2

 

Table 2. Patient Characteristics According to Change in the Number of CBDS Between First and Second ERC
 
VariablesChange in number of CBDS between first and second ERCP value
Increased (group A) (n = 15)Unchanged or decreased (group B) (n = 24)
Results are presented as the number (n) or mean n (%) for qualitative data or as the median (range) for quantitative data. *P < 0.05. GS: gallstones; CBDS: common bile duct stones; ERC: endoscopic retrograde cholangiography.
Gender, female7 (46.6%)12 (50%)0.55
Age, years71 (40-89)66 (45-84)0.211
Maximum diameter of GS, mm7 (2-22)7 (2-30)0.233
Patients with multiple GS (≥ 5)9 (60%)12 (50%)0.55
Cholangitis on admission5 (33.3%)10 (41.6%)0.43
Maximum diameter of CBDS, mm4 (0 - 11)5 (0 - 11)0.976
Patients with multiple CBDS (≥ 5)4 (26.6%)2 (8.3%)0.139
Minimal diameter of cystic duct, mm5 (1 - 8)3 (1 - 7)0.022*
Residual CBDS at first ERC0 (0%)5 (20.8%)0.074
Days between first ERC and operation28 (12 - 131)23 (2 - 97)0.176
Laparoscopic cholecystectomy13 (86.6%)24 (100%)0.142
Operation time, min95 (56 - 163)94 (48 - 260)0.959
Days between operation and second ERC44 (31 - 92)40 (26 - 96)0.866

 

Table 3. Factors Associated With the Development of Recurrent CBDS After Endoscopic Treatment for CBDS Around the Perioperative Period in Cholecystectomy
 
Univariate OR (95% CI)P valueMultivariate OR (95% CI)P value
Results are presented as a number (n) or mean n (%) for qualitative data or as median (range) for quantitative data. *P < 0.05. GS: gallstones; CBDS: common bile duct stones; ERC: endoscopic retrograde cholangiography; CI: confidence interval.
Gender, female1.143 (0.314 - 4.160)0.839
Age, years0.961 (0.903 - 1.023)0.211
Maximum diameter of GS, mm1.083 (0.949 - 1.236)0.238
Patients with multiple GS (≥ 5)1.143 (0.314 - 4.160)0.839
Cholangitis on admission1.429 (0.372 - 5.487)0.603
Maximum diameter of CBDS, mm0.997 (0.816 - 1.218)0.975
Patients with multiple CBDS (≥ 5)0.250 (0.039 - 1.582)0.1410.218 (0.030 - 1.586)0.132
Minimal diameter of cystic duct, mm0.664 (0.459 - 0.962)0.03*0.611 (0.398 - 0.939)0.025*
Residual CBDS at first ERC0.999
Days between first ERC and operation0.984 (0.962 - 1.008)0.1850.974 (0.946 - 1.003)0.084
Laparoscopic cholecystectomy0.999
Operation time, min1.000 (0.984 - 1.017)0.958
Days between operation and second ERC0.997 (0.959 - 1.036)0.862