Muhammad T, He TT, Lin ZY, Shi JL, Zhang TG, Yang Y, Yang XL, Chattha HN, Li J. Impact of chronic proliferative cholangitis on stone recurrence and biliary strictures after intrahepatic stone treatment: A meta-analysis. World J Gastrointest Surg 2026; 18(3): 116913 [DOI: 10.4240/wjgs.v18.i3.116913]
Corresponding Author of This Article
Jiang Li, MD, PhD, Chairman, Consultant, Full Professor, Researcher, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang Road, Wuhua District, Kunming 650032, Yunnan Province, China. lijiang44@yeah.net
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Gastroenterology & Hepatology
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Meta-Analysis
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Mar 27, 2026 (publication date) through Mar 30, 2026
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Publication Name
World Journal of Gastrointestinal Surgery
ISSN
1948-9366
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Muhammad T, He TT, Lin ZY, Shi JL, Zhang TG, Yang Y, Yang XL, Chattha HN, Li J. Impact of chronic proliferative cholangitis on stone recurrence and biliary strictures after intrahepatic stone treatment: A meta-analysis. World J Gastrointest Surg 2026; 18(3): 116913 [DOI: 10.4240/wjgs.v18.i3.116913]
World J Gastrointest Surg. Mar 27, 2026; 18(3): 116913 Published online Mar 27, 2026. doi: 10.4240/wjgs.v18.i3.116913
Impact of chronic proliferative cholangitis on stone recurrence and biliary strictures after intrahepatic stone treatment: A meta-analysis
Tauqeer Muhammad, Ting-Ting He, Zhu-Ying Lin, Jia-Lin Shi, Tian-Gui Zhang, Yao Yang, Xiao-Lei Yang, Hashim Nazir Chattha, Jiang Li
Tauqeer Muhammad, Ting-Ting He, Zhu-Ying Lin, Jia-Lin Shi, Tian-Gui Zhang, Yao Yang, Xiao-Lei Yang, Jiang Li, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan Province, China
Hashim Nazir Chattha, Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan Province, China
Co-first authors: Tauqeer Muhammad and Ting-Ting He.
Author contributions: Tauqeer M and He TT conceived and designed the study, and they contributed equally to this manuscript and are co-first authors; Tauqeer M, He TT, Shi JL, Zhang TG, Yao Y, and Yang XL conducted the literature search; Lin ZY drafted and made critical revisions to the manuscript; Chattha HN has made critical review to language; Li J provided final approval of the version to be published.
Supported by the 2024 “Xingdian Talents” Support Project of Yunnan Province.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Jiang Li, MD, PhD, Chairman, Consultant, Full Professor, Researcher, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Kunming Medical University, No. 295 Xichang Road, Wuhua District, Kunming 650032, Yunnan Province, China. lijiang44@yeah.net
Received: November 25, 2025 Revised: December 25, 2025 Accepted: February 2, 2026 Published online: March 27, 2026 Processing time: 123 Days and 11.3 Hours
Abstract
BACKGROUND
Intrahepatic bile duct stones often come back after treatment. One possible cause is chronic proliferative cholangitis (CPC). This is a long-term inflammation of the bile ducts that can cause scarring and narrowing. This inflammation may remain even after stones are removed. Its effect on stone recurrence and bile duct narrowing is still unclear. We hypothesized that CPC increases the risk of stone recurrence and bile duct strictures after treatment.
AIM
To determine whether CPC is associated with stone recurrence and bile duct strictures after treatment.
METHODS
We performed a systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. PubMed, Scopus, Web of Science, and ScienceDirect were searched for studies published from 2015 to 2025. Only observational studies in adults treated for intrahepatic bile duct stones were included. Two reviewers independently collected data. Pooled results were calculated using random-effects statistical models.
RESULTS
Six observational studies including 1248 patients were analyzed. Stone removal was successful in 91% of patients. Stone recurrence occurred in 21.5% of patients. Bile duct narrowing occurred in 18% of patients. Adverse events occurred in 12% of patients. Studies reporting chronic bile duct inflammation showed higher rates of stone recurrence and bile duct narrowing. Differences between studies were moderate.
CONCLUSION
Stone removal is effective, but stones and bile duct narrowing often return, especially with chronic bile duct inflammation. Treating inflammation may help improve long-term results.
Core Tip: This study reviews the impact of chronic proliferative cholangitis on stone recurrence and biliary stricture formation after the treatment of intrahepatic bile duct stones. Where we have found that removal of stone can be effective but it can be returned with inflammation, and the treatment of that inflammation can improve the long-term results.
