S-Space College of Medicine/School of Medicine (의과대학/대학원) Internal Medicine (내과학전공) Journal Papers (저널논문_내과학전공)
Does endoscopic sphincterotomy reduce the recurrence rate of cholangitis in patients with cholangitis and suspected of a common bile duct stone not detected by ERCP?
- Lee, Sang Hyub; Hwang, Jin-Hyeok; Yang, Ki Young; Lee, Kwang Hyuck; Park, Young Soo; Park, Joo Kyung; Woo, Sang Myung; Yoo, Ji Won; Ryu, Ji Kon; Kim, Yong-Tae; Yoon, Yong Bum
- Issue Date
- Gastrointest Endosc. 2008 ;67(1):51-7.
- Adult; Aged; Aged, 80 and over; *Cholangiopancreatography, Endoscopic Retrograde; Cholangitis/etiology/*prevention & control; Female; Gallstones/complications/*diagnosis; Humans; Male; Middle Aged; Prognosis; Recurrence/prevention & control; Retrospective Studies; *Sphincterotomy, Endoscopic; Treatment Outcome
- BACKGROUND: It has not been established whether endoscopic sphincterotomy (ES) prevents subsequent cholangitis in patients with cholangitis and with a common bile duct (CBD) stone not documented by ERCP. OBJECTIVE: The aim of this study was to investigate the role of ES on the recurrence of cholangitis in patients with a high probability of having a CBD stone, not demonstrated by ERCP. DESIGN AND PATIENTS: A total of 117 patients who were diagnosed as having cholangitis and a high probability of a CBD stone, not detected by ERCP, were retrospectively reviewed. Cumulative recurrence rates of cholangitis were compared for treatments with and without ES. SETTING: Multicenter, retrospective study. INTERVENTIONS: ES. MAIN OUTCOME MEASUREMENTS: Cumulative recurrence of cholangitis after ERCP. RESULTS: Eighty-three patients underwent ES (ES group) and 34 patients did not (non-ES group). No statistically significant differences between the 2 groups were evident in terms of demographic factors or laboratory findings. The mean (standard deviation) follow-up was 22.1 +/- 17.2 months (range 3-66 months) in the ES group and 23.3 +/- 14.9 months (range 6-84 months) in the non-ES group (P = .72). The cumulative rates of cholangitis were 6.3% (4.8% vs 9.9%) at 1 year, 15.6% (9.2% vs 29.3%) at 3 years, and 19.5% (9.2% vs 52.9%) at 5 years for ES vs non-ES groups, respectively (P = .04). By multivariate analysis, ES reduced cholangitis recurrence, with a hazard ratio of 0.305 (95% CI 0.095-0.975, P = .045). LIMITATIONS: Retrospective study. CONCLUSIONS: ES reduced further episodes of cholangitis in patients with an episode of cholangitis and a high probability of choledocholithiasis, despite the lack of a CBD stone seen on ERCP.
- 0016-5107 (Print)
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