Cao Z, Zhou J, Wei L, He HY, Li J. Effect of the extrahepatic bile duct anatomy on choledocholithiasis and its clinical significance. World J Gastrointest Surg 2024; 16(5): 1363-1370 [PMID: 38817273 DOI: 10.4240/wjgs.v16.i5.1363]
Corresponding Author of This Article
Jun Li, MD, Chief, Professor, Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University, No. 374 Dianmian Avenue, Wuhua District, Kunming 650000, Yunnan Province, China. 961983787@qq.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. May 27, 2024; 16(5): 1363-1370 Published online May 27, 2024. doi: 10.4240/wjgs.v16.i5.1363
Effect of the extrahepatic bile duct anatomy on choledocholithiasis and its clinical significance
Zheng Cao, Jia Zhou, Li Wei, Hai-Yu He, Jun Li
Zheng Cao, Jia Zhou, Li Wei, Hai-Yu He, Jun Li, Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University, Kunming 650000, Yunnan Province, China
Author contributions: Cao Z designed and performed the research and wrote the paper; Zhou J designed the research and supervised the report; Wei L and He HY designed the research and contributed to the analysis; Li J supervised the report.
Supported byKunming Medical University, No. 2023S090.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Second Affiliated Hospital of Kunming Medical University (Approval No. 2023-234).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors have declared that no competing interests exist.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun Li, MD, Chief, Professor, Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University, No. 374 Dianmian Avenue, Wuhua District, Kunming 650000, Yunnan Province, China. 961983787@qq.com
Received: February 18, 2024 Revised: March 7, 2024 Accepted: April 3, 2024 Published online: May 27, 2024 Processing time: 95 Days and 2.9 Hours
Abstract
BACKGROUND
A comprehensive understanding of the extrahepatic bile duct anatomy is vital to guide surgical procedures and perform endoscopic retrograde cholangiography. Anatomical irregularities within the extrahepatic bile duct may increase susceptibility to bile duct stones.
AIM
To investigate the anatomical risk factors associated with extrahepatic bile ducts in patients diagnosed with choledocholithiasis, with a specific focus on preventing stone recurrence after surgical intervention and endoscopic lithotomy.
METHODS
We retrospectively analyzed the medical records of 124 patients without choledocholithiasis and 108 with confirmed choledocholithiasis who underwent magnetic resonance cholangiopancreatography examinations at our center between January 2022 and October 2022. Logistic regression analyses were conducted to identify the anatomical risk factors influencing the incidence of common bile duct stones.
RESULTS
Multivariate logistic regression analysis revealed that several factors independently contributed to choledocholithiasis risk. Significant independent risk factors for choledocholithiasis were diameter of the common hepatic [adjusted odds ratio (aOR) = 1.43, 95% confidence interval (CI): 1.07-1.92, adjusted P value = 0.016] and common bile (aOR = 1.68, 95%CI: 1.27-2.23, adjusted P value < 0.001) ducts, length of the common hepatic duct (aOR = 0.92, 95%CI: 0.84-0.99, adjusted P value = 0.034), and angle of the common bile duct (aOR = 0.92, 95%CI: 0.89–0.95, adjusted P value < 0.001).
CONCLUSION
The anatomical features of the extrahepatic bile duct were directly associated with choledocholithiasis risk. Key risk factors include an enlarged diameter of the common hepatic and bile ducts, a shorter length of the common hepatic duct, and a reduced angle of the common bile duct.
Core Tip: Comprehensive understanding of the extrahepatic bile duct anatomy is imperative to guide surgical procedures and perform endoscopic retrograde cholangiography. This study aimed to investigate the anatomical risk factors associated with the extrahepatic bile ducts in patients diagnosed with choledocholithiasis, specifically focusing on preventing stone recurrence after surgical intervention and endoscopic lithotomy. Several independent risk factors for choledocholithiasis were identified in our retrospective analysis of medical records. Noteworthy factors include an enlarged diameter of the common hepatic and bile ducts, a shorter length of the common hepatic duct, and a reduced angle of the common bile duct. Our findings underscore the significance of these anatomical features in the incidence of common bile duct stones. Our findings provide valuable insights into the relationship between extrahepatic bile duct anatomy and choledocholithiasis risk.
