Recurrence of common bile duct stones after endoscopic clearance and its predictors: A systematic review

Abstract Background The primary therapeutic strategy for the management of bile duct stones (BDS) is endoscopic retrograde cholangiopancreatography. However, there may be a recurrence of BDS on follow‐up. Multiple risk factors have been studied for the prediction of BDS recurrence. We aimed to analy...

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Main Authors: Marko Kozyk, Suprabhat Giri, Sidharth Harindranath, Manan Trivedi, Kateryna Strubchevska, Rakesh Kumar Barik, Sridhar Sundaram
Format: Article
Language:English
Published: Wiley 2024-04-01
Series:DEN Open
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Online Access:https://doi.org/10.1002/deo2.294
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author Marko Kozyk
Suprabhat Giri
Sidharth Harindranath
Manan Trivedi
Kateryna Strubchevska
Rakesh Kumar Barik
Sridhar Sundaram
author_facet Marko Kozyk
Suprabhat Giri
Sidharth Harindranath
Manan Trivedi
Kateryna Strubchevska
Rakesh Kumar Barik
Sridhar Sundaram
author_sort Marko Kozyk
collection DOAJ
description Abstract Background The primary therapeutic strategy for the management of bile duct stones (BDS) is endoscopic retrograde cholangiopancreatography. However, there may be a recurrence of BDS on follow‐up. Multiple risk factors have been studied for the prediction of BDS recurrence. We aimed to analyze the incidence of symptomatic BDS recurrence, systematically review the risk factors, and analyze the most important risk factors among those. Methods A comprehensive search of three databases was conducted from inception to November 2022 for studies reporting the recurrence of BDS recurrence after endoscopic retrograde cholangiopancreatography with clearance, along with an analysis of risk factors. Results A total of 37 studies with 12,952 patients were included in the final analysis. The pooled event rate for the recurrence of BDS stones was 12.6% (95% confidence interval: 11.2–13.9). The most important risk factor was a bile duct diameter ≥15 mm, which had a significant association with recurrence in twelve studies. Other risk factors with significant association with recurrence in three or more studies were the reduced angulation of the bile duct, the presence of periampullary diverticulum, type I periampullary diverticulum, in‐situ gallbladder with stones, cholecystectomy, multiple stones in the bile duct, use of mechanical lithotripsy, and bile duct stent placement. Conclusion Around one out of seven patients have BDS recurrence after the initial endoscopic retrograde cholangiopancreatography. Bile duct size and anatomy are the most important predictors of recurrence. The assessment of risk factors associated with recurrence may help keep a close follow‐up in high‐risk patients.
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spelling doaj-art-333edf1d9c5d4f5e94ed0b8393d8a14b2025-08-20T03:41:00ZengWileyDEN Open2692-46092024-04-0141n/an/a10.1002/deo2.294Recurrence of common bile duct stones after endoscopic clearance and its predictors: A systematic reviewMarko Kozyk0Suprabhat Giri1Sidharth Harindranath2Manan Trivedi3Kateryna Strubchevska4Rakesh Kumar Barik5Sridhar Sundaram6Department of Internal Medicine Corewell Health William Beaumont University Hospital Royal Oak Michigan USADepartment of Gastroenterology & Hepatology Kalinga Institute of Medical Sciences Bhubaneswar IndiaDepartment of Gastroenterology Seth GS Medical College and KEM Hospital Mumbai IndiaDepartment of General Surgery KB Bhabha Hospital Mumbai IndiaDepartment of Internal Medicine Corewell Health William Beaumont University Hospital Royal Oak Michigan USADepartment of Gastroenterology Indian Institute of Gastroenterology and Hepatology Cuttack IndiaDepartment of Digestive Diseases and Clinical Nutrition Tata Memorial Hospital Mumbai IndiaAbstract Background The primary therapeutic strategy for the management of bile duct stones (BDS) is endoscopic retrograde cholangiopancreatography. However, there may be a recurrence of BDS on follow‐up. Multiple risk factors have been studied for the prediction of BDS recurrence. We aimed to analyze the incidence of symptomatic BDS recurrence, systematically review the risk factors, and analyze the most important risk factors among those. Methods A comprehensive search of three databases was conducted from inception to November 2022 for studies reporting the recurrence of BDS recurrence after endoscopic retrograde cholangiopancreatography with clearance, along with an analysis of risk factors. Results A total of 37 studies with 12,952 patients were included in the final analysis. The pooled event rate for the recurrence of BDS stones was 12.6% (95% confidence interval: 11.2–13.9). The most important risk factor was a bile duct diameter ≥15 mm, which had a significant association with recurrence in twelve studies. Other risk factors with significant association with recurrence in three or more studies were the reduced angulation of the bile duct, the presence of periampullary diverticulum, type I periampullary diverticulum, in‐situ gallbladder with stones, cholecystectomy, multiple stones in the bile duct, use of mechanical lithotripsy, and bile duct stent placement. Conclusion Around one out of seven patients have BDS recurrence after the initial endoscopic retrograde cholangiopancreatography. Bile duct size and anatomy are the most important predictors of recurrence. The assessment of risk factors associated with recurrence may help keep a close follow‐up in high‐risk patients.https://doi.org/10.1002/deo2.294bile duct stonecholecystectomyERCPgallstone diseasemeta‐analysis
spellingShingle Marko Kozyk
Suprabhat Giri
Sidharth Harindranath
Manan Trivedi
Kateryna Strubchevska
Rakesh Kumar Barik
Sridhar Sundaram
Recurrence of common bile duct stones after endoscopic clearance and its predictors: A systematic review
DEN Open
bile duct stone
cholecystectomy
ERCP
gallstone disease
meta‐analysis
title Recurrence of common bile duct stones after endoscopic clearance and its predictors: A systematic review
title_full Recurrence of common bile duct stones after endoscopic clearance and its predictors: A systematic review
title_fullStr Recurrence of common bile duct stones after endoscopic clearance and its predictors: A systematic review
title_full_unstemmed Recurrence of common bile duct stones after endoscopic clearance and its predictors: A systematic review
title_short Recurrence of common bile duct stones after endoscopic clearance and its predictors: A systematic review
title_sort recurrence of common bile duct stones after endoscopic clearance and its predictors a systematic review
topic bile duct stone
cholecystectomy
ERCP
gallstone disease
meta‐analysis
url https://doi.org/10.1002/deo2.294
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