Seo DB, Bang BW, Jeong S, Lee DH, Park SG, Jeon YS, Lee JI, Lee JW. Does the bile duct angulation affect recurrence of choledocholithiasis? World J Gastroenterol 2011; 17(36): 4118-4123 [PMID: 22039327 DOI: 10.3748/wjg.v17.i36.4118]
Corresponding Author of This Article
Don Haeng Lee, MD, Department of Internal Medicine, Inha University Hospital, 7-206, 3-Ga, Sinheung-Dong, Jung-Gu, Incheon 400-711, South Korea. ldh@inha.ac.kr
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World J Gastroenterol. Sep 28, 2011; 17(36): 4118-4123 Published online Sep 28, 2011. doi: 10.3748/wjg.v17.i36.4118
Does the bile duct angulation affect recurrence of choledocholithiasis?
Dong Beom Seo, Byoung Wook Bang, Seok Jeong, Don Haeng Lee, Shin Goo Park, Yong Sun Jeon, Jung Il Lee, Jin-Woo Lee
Dong Beom Seo, Byoung Wook Bang, Seok Jeong, Jung Il Lee, Jin-Woo Lee, Division of Gastroenterology, Department of Internal Medicine, Inha University School of Medicine, Incheon 400-711, South Korea
Don Haeng Lee, Division of Gastroenterology, Department of Internal Medicine and Center for Advanced Medical Education by BK21 Project, Inha University School of Medicine, and Utah-Inha DDS and Advanced Therapeutics Research Center, Incheon 400-711, South Korea
Shin Goo Park, Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon 400-711, South Korea
Yong Sun Jeon, Department of Radiology, Inha University School of Medicine, Incheon, 400-711, South Korea
Author contributions: Seo DB and Bang BW wrote the paper; all authors performed research and collected the data; Park SG analyzed the data; Jeong S and Lee DH reviewed the paper; Jeon YS, Lee JI, Lee JW provided technical support and advice.
Supported by An Inha University Research Grant
Correspondence to: Don Haeng Lee, MD, Department of Internal Medicine, Inha University Hospital, 7-206, 3-Ga, Sinheung-Dong, Jung-Gu, Incheon 400-711, South Korea. ldh@inha.ac.kr
Telephone: +82-32-8902548 Fax: +82-32-8902549
Received: September 26, 2010 Revised: March 24, 2011 Accepted: March 31, 2011 Published online: September 28, 2011
Abstract
AIM: To investigate whether bile duct angulation and T-tube choledochostomy influence the recurrence of choledocholithiasis.
METHODS: We conducted a retrospective study inclu-ding 259 patients who underwent endoscopic sphincterotomy and cholecystectomy for choledocholithiasis between 2000 and 2007. The imaginary line was drawn along the center of the bile duct and each internal angle was measured at the two angulation sites of the bile duct respectively. The values of both angles were added together. We then tested our hypothesis by examining whether T-tube choledochostomy was performed and stone recurrence occurred by reviewing each subject’s medical records.
RESULTS: The overall recurrence rate was 9.3% (24 of 259 patients). The mean value of sums of angles in the recurrence group was 268.3°± 29.6°, while that in the non-recurrence group was 314.8°± 19.9° (P < 0.05). Recurrence rate of the T-tube group was 15.9% (17 of 107), while that of the non T-tube group was 4.6% (7 of 152) (P < 0.05). Mean value of sums of angles after T-tube drainage was 262.5°± 24.6° and that before T-tube drainage was 298.0°± 23.9° in 22 patients (P < 0.05).
CONCLUSION: The bile duct angulation and T-tube choledochostomy may be risk factors of recurrence of bile duct stones.
