Risk Factors of Acute Cholecystitis After Endoscopic Common Bile Duct Stone Removal

Overview

Journal World J Gastroenterol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2006 Mar 8

PMID 16521227

Citations 8

Authors

Jun Kyu Lee

Ji Kon Ryu

Joo Kyung Park

Won Jae Yoon

Sang Hyub Lee

Kwang Hyuck Lee

Yong-Tae Kim

Yong Bum Yoon

Affiliations

Soon will be listed here.

Abstract

Aim: To evaluate the risk factors of acute cholecystitis after endoscopic common bile duct (CBD) stone removal.

Methods: A total 100 of patients who underwent endoscopic CBD stone removal with gallbladder (GB) in situ without subsequent cholecystectomy from January 2000 to July 2004 were evaluated retrospectively. The following factors were considered while evaluating risk factors for the development of acute cholecystitis: age, gender, serum bilirubin level, GB wall thickening, cystic duct patency, presence of a GB stone, CBD diameter, residual stone, lithotripsy, juxtapapillary diverticulum, presence of liver cirrhosis or diabetes mellitus, a presenting illness of cholangitis or pancreatitis, and procedure-related complications.

Results: During a mean 18-mo follow-up, 28 (28%) patients developed biliary symptoms; 17 (17%) acute cholecystitis and 13 (13%) CBD stone recurrence. Of patients with acute cholecystitis, 15 (88.2%) received laparoscopic cholecystectomy and 2 (11.8%) open cholecystectomy. All recurrent CBD stones were successfully removed endoscopically. The mean time elapse to acute cholecystitis was 10.2 mo (1-37 mo) and that to recurrent CBD stone was 18.4 mo. Of the 17 patients who received cholecystectomy, 2 (11.8%) developed recurrent CBD stones after cholecystectomy. By multivariate analysis, a serum total bilirubin level of <1.3 mg/dL and a CBD diameter of <11 mm at the time of stone removal were found to predict the development of acute cholecystitis.

Conclusion: After CBD stone removal, there is no need for routine prophylactic cholecystectomy. However, patients without a dilated bile duct (<11 mm) and jaundice (<1.3 mg/dL) at the time of CBD stone removal have a higher risk of acute cholecystitis and are possible candidates for prophylactic cholecystectomy.

Citing Articles

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Delay for cholecystectomy after common bile duct clearance with ERCP is just running after recurrent biliary event.

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Optimal Timing of Cholecystectomy for Patients with Concurrent Acute Cholecystitis and Acute Cholangitis after Successful Biliary Drainage by Interventional Endoscopic Retrograde Cholangiopancreatography.

Chang Y, Wu C, Chen H, Hung Y, Hu C, Huang R J Clin Med. 2022; 11(21).

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A novel machine learning model and a public online prediction platform for prediction of post-ERCP-cholecystitis (PEC).

Zhang X, Yue P, Zhang J, Yang M, Chen J, Zhang B EClinicalMedicine. 2022; 48:101431.

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Classification of the cystic duct patterns and endoscopic transpapillary cannulation of the gallbladder to prevent post-ERCP cholecystitis.

Cao J, Ding X, Wu H, Shen Y, Zheng R, Peng C BMC Gastroenterol. 2019; 19(1):139.

PMID: 31382888 PMC: 6683449. DOI: 10.1186/s12876-019-1053-6.

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