Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.
Gut Liver. 2011 Mar;5(1):65-9. doi: 10.5009/gnl.2011.5.1.65. Epub 2011 Mar 16.
BACKGROUND/AIMS: To investigate the efficacy of early scheduled follow-up endoscopic retrograde cholangiopancreatography (ERCP) after common bile duct (CBD) stone removal.
Patients who underwent endoscopic CBD stone removal and who had at least one risk factor for stone recurrence were enrolled. Six months after complete clearance of the CBD, patients underwent follow-up ERCP at an ambulatory care center, irrespective of symptoms.
The incidence of symptoms and cholangitis at follow-up ERCP was significantly lower in Group A (ERCP at 6 months after stone removal) than that in Group B (ERCP at >6 months) (14.3% vs 71.4%, p=0.00; 9.5% vs 33.3%, p=0.02, respectively). However, the recurrence rates of CBD stones were not different between Groups A and B (33.3% vs 47.6%). When comparing the subgroups, Group AR (stone recurrence in Group A) displayed significantly fewer symptoms and lesser cholangitis and spent fewer days in the hospital than did Group BR (stone recurrence in Group B) (21.4% vs 70%, p=0.02; 14.3% vs 60%, p=0.02; 2.43±1.87 vs 6.10±3.35, p=0.00, respectively).
Our data suggest that, irrespective of symptoms, early scheduled follow-up ERCP for patients who are at a high risk of recurrence is effective and safe.
背景/目的：研究胆总管（CBD）结石取石术后早期计划内镜逆行胰胆管造影（ERCP）的疗效。
招募接受内镜 CBD 结石取石术且至少有一个结石复发风险因素的患者。在 CBD 完全清除后 6 个月，无论症状如何，患者均在门诊护理中心接受随访 ERCP。
在 A 组（结石清除后 6 个月进行 ERCP），症状和胆管炎的发生率明显低于 B 组（>6 个月进行 ERCP）（14.3% vs 71.4%，p=0.00；9.5% vs 33.3%，p=0.02）。然而，CBD 结石的复发率在 A 组和 B 组之间没有差异（33.3% vs 47.6%）。在亚组比较中，A 组 R（A 组结石复发）的症状和胆管炎明显少于 B 组 R（B 组结石复发）（21.4% vs 70%，p=0.02；14.3% vs 60%，p=0.02；2.43±1.87 vs 6.10±3.35，p=0.00）。
我们的数据表明，对于高复发风险的患者，无论症状如何，早期计划进行随访 ERCP 是有效且安全的。
