Risk factors for the late development of common bile duct stones after laparoscopic cholecystectomy

초록

Background: The development of common bile duct (CBD) stones after laparoscopic cholecystectomy (LC) could be a stressful event for surgeons and patients. The purpose of this study was to investigate the risk factors for and the time of occurrence of CBD stones, which are detected at a certain period after LC in patients who have no history of having CBD stone before operation. Methods: A total of 1938 patients who underwent LC for benign gallbladder lesion were retrospectively analyzed. The patients were categorized into two groups according to the development of CBD stones at least 6 months after LC (case group, control group). The risk factors for and the time of development of CBD stones after LC were evaluated. Results: In a univariate analysis, the significant factors for the development of CBD stones were old age, acute cholecystitis, the presence of periampullary diverticulum, and the presence of gall bladder stones sized <0.55 cm. By multivariate analysis, acute cholecystitis (OR: 3.082, 95% CI: 1.306–7.272, p = 0.010), the presence of periampullary diverticulum (OR: 7.950, 95% CI: 3.425–18.457, p < 0.001), and the presence of gall bladder stones sized < 0.55 cm (OR: 5.647, 95% CI: 1.310–24.346, p = 0.020) were independent factors that could predict the development of CBD stones at least 6 months after LC. The time intervals of the development of CBD stones had evenly distributed during 50 months after LC. Conclusion: This study suggested that the surgeon should inform the possibility of the development of CBD stones who have the identified risk factors.

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