Kim Chang Whan, Chang Jae Hyuck, Lim Yeon Soo, Kim Tae Ho, Lee In Seok, Han Sok Won
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
J Dig Dis. 2014 Jan;15(1):35-41. doi: 10.1111/1751-2980.12100.
To investigate the time and extent of recovery of dilated common bile duct (CBD) after the extraction of CBD stones and to identify the factors related to the long-term dilatation of the CBD after stone removal.
Data of 329 consecutive patients undergoing endoscopic extraction of CBD stones from January 2008 to December 2012 were retrospectively reviewed. Finally, 44 patients were enrolled in the study.
The CBD diameter significantly decreased after stone extraction (P < 0.001). However, the CBD diameter in patients who were followed up for 1 week and longer and <1 week did not differ significantly. The diameter decreased more in patients with an initial CBD diameter ≥ 15 mm than in those with an initial CBD diameter <15 mm before stone extraction (P = 0.007), but the normalization of dilated CBD was less frequent in patients with a large initial CBD diameter. The factors related to the long-term dilatation of CBD (>10 mm for >6 months) were initial CBD diameter, the largest diameter of CBD stone and endoscopic papillary large balloon dilatation. Initial CBD diameter was an independent factor with multivariate analysis (OR 1.754, P = 0.017).
The CBD diameter recovers rapidly after the extraction of CBD stones. An initial large CBD diameter before stone extraction is associated with the long-term dilatation of CBD.
探讨胆总管结石取出术后扩张胆总管（CBD）的恢复时间及程度，并确定结石取出后胆总管长期扩张的相关因素。
回顾性分析2008年1月至2012年12月连续329例行内镜下胆总管结石取出术患者的数据。最终，44例患者纳入研究。
结石取出后胆总管直径显著减小（P < 0.001）。然而，随访1周及以上和不足1周的患者胆总管直径差异无统计学意义。结石取出术前初始胆总管直径≥15 mm的患者直径减小幅度大于初始胆总管直径<15 mm的患者（P = 0.007），但初始胆总管直径大的患者扩张胆总管恢复正常的频率较低。与胆总管长期扩张（>6个月直径>10 mm）相关的因素有初始胆总管直径、胆总管结石最大直径和内镜乳头大球囊扩张。多因素分析显示初始胆总管直径是独立因素（OR 1.754，P = 0.017）。
胆总管结石取出术后胆总管直径迅速恢复。结石取出术前初始胆总管直径大与胆总管长期扩张有关。
