Outcomes of endoscopic sphincterotomy vs open choledochotomy for common bile duct stones

Table 3 Procedure-related long-term outcomes of endoscopic sphincterotomy and open choledochotomy

Long-term outcome measure		Before matching			After matching
		EST (n = 168)	OCT (n = 134)	P-value	EST (n = 88)	OCT (n = 88)	P-value
Recurrent bile duct stones, n (%)		29 (17.3)	32 (23.9)	0.155	18 (20.5)	15 (17.0)	0.562
	With AC	4 (2.4)	12 (8.9)	0.036a	2 (2.4)	6 (8.9)	0.054
	Without AC	25 (14.9)	20 (14.9)		16 (14.9)	9 (14.9)
Time to initial recurrence, mean ± SD, yr		2.8 ± 2.0	3.5 ± 2.2	0.183	3.0 ± 2.2	3.9 ± 2.7	0.321
Times of recurrence ≥ 2, n (%)		6 (3.6)	11 (8.2)	0.082	3 (3.4)	4 (4.5)	0.700
Reintervention rate, n (%)		24 (14.3)	29 (21.6)	0.095	15 (17.0)	14 (15.9)	0.839
Reintervention method, n (%)				0.002b			0.032a
	EST	23 (13.7)	115 (11.2)		14 (15.9)	17 (7.9)
	OCT	1 (0.6)	13 (9.7)		1 (1.1)	6 (6.8)
	LCBDE	0	1 (0.7)		0	1 (1.1)
Mortality, n (%)		14 (8.3)	11 (8.2)	0.969	10 (11.4)	9 (10.2)	0.808
	Procedure-related	0	0	-	0	0	-
	Cholangiocarcinoma	0	2 (1.5)	0.112	0	1 (1.1)	0.316
	Cardiopulmonary complication	8 (4.8)	4 (3.0)	0.432	7 (7.9)	4 (4.5)	0.350
	Unknown etiology	6 (3.6)	5 (3.7)	0.941	3 (3.4)	4 (4.5)	0.700

¹In the open choledochotomy group, 15 reinterventions for endoscopic sphincterotomy were required due to purely recurrent common bile duct stones (CBDS) (n = 8), recurrent CBDS with acute cholangitis (n = 6), or recurrent CBDS with cholangiocarcinoma (n = 1).

^aP < 0.05.

^bP < 0.01.

EST: Endoscopic sphincterotomy; OCT: Open choledochotomy; AC: Acute cholangitis; LCBDE: Laparoscopic common bile duct exploration; SD: Standard deviation; IQR: Interquartile range.