Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jan 27, 2024; 16(1): 103-112
Published online Jan 27, 2024. doi: 10.4240/wjgs.v16.i1.103
Risk factors for recurrence of common bile duct stones after surgical treatment and effect of ursodeoxycholic acid intervention
Tao Yuan, Bo-Neng Mao, Qi Pan, Zheng Zhang, Wei-Hong Yuan
Wei-Hong Yuan, Zheng Zhang, Qi Pan, Bo-Neng Mao, Tao Yuan, Department of Gastroenterology, Yixing People’s Hospital, Yixing 214200, Jiangsu Province, China
Author contributions: Yuan WH designed and wrote the paper; Yuan T designed the research and supervised the report; Zhang Z, Pan Q and Mao BN designed the research and contributed to the analysis; all authors have approved the manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Yixing People’s Hospital.
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 declare no conflict of interest.
Data sharing statement: The clinical data used in this study can be obtained from the corresponding author upon request.
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: Tao Yuan, MM, Attending Doctor, Department of Gastroenterology, Yixing People’s Hospital, No. 1588 Xincheng Road, Yixing 214200, Jiangsu Province, China. staff1848@yxph.com
Received: November 3, 2023
Peer-review started: November 3, 2023
First decision: November 16, 2023
Revised: November 29, 2023
Accepted: January 2, 2024
Article in press: January 2, 2024
Published online: January 27, 2024
Processing time: 83 Days and 2.9 Hours
ARTICLE HIGHLIGHTS
Research background

Endoscopic retrograde cholangiopancreatography (ERCP) is a commonly used modality for the treatment of choledocholithiasis, with a stone clearance rate of up to 95%; however, the recurrence rate has not decreased. Ursodeoxycholic acid (UDCA) is a postoperative drug used to prevent stone recurrence; however, its effectiveness is yet to be explored. Therefore, this study focused on biliopancreatic surgery to investigate the interventional effect of UDCA after ERCP for choledocholithiasis and analyze the risk factors for recurrence.

Research motivation

Recurrence of choledocholithiasis after ERCP brings pain to patients; therefore, this paper retrospectively analyzes the intervention effect of UDCA after ERCP for choledocholithiasis and the risk factors of recurrence, in order to provide a new research direction and reference for the prevention and treatment of stone recurrence.

Research objectives

To analyze the intervention effect of the prophylactic use of UDCA after ERCP and the influencing factors of postoperative recurrence, and to explain the mechanism of action.

Research methods

The clinical records of 100 cases after ERCP were retrospectively selected, the therapeutic effects of non-UDCA and UDCA after ERCP and their effects on liver function were evaluated, and the rate of relapse within the two patient populations was compared. The risk factors for relapse were determined.

Research results

The clinical efficacy rates were 92.45% in UDCA group and 78.72% in control groups. The factors associated with recurrence after ERCP for choledochal stones included parapapillary diverticulum, number of stones > 3, positive bile culture, postoperative UDCA, and maximum stone diameter.

Research conclusions

The administration of UDCA to patients with common bile duct stones following ERCP can enhance liver function recovery and effectively decrease relapse.

Research perspectives

Future studies should explore the relevant mechanisms of action of UDCA treatment and construct a risk prediction model to evaluate its clinical benefits.