Clinical Impact of Common Bile Duct Angulation on the Recurrence of Common Bile Duct Stone: A Meta-analysis and Review
Background/Aims: Local and systemic factors, such as diabetes, obesity, and hyperlipidemia, are considered risk factors for the recurrence of choledocholithiasis after successful endoscopic clearance. Local factors include the presence of bile sludge, common bile duct (CBD) diameter, and CBD angula...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Jin Publishing & Printing Co.
2020-10-01
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| Series: | The Korean Journal of Gastroenterology |
| Subjects: | |
| Online Access: | http://www.kjg.or.kr/journal/view.html?uid=5628&vmd=Full |
| _version_ | 1818911406388412416 |
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| author | Seongyul Ryu Ik Hyun Jo Seonhoo Kim Yeon-Ji Kim Woo Chul Chung |
| author_facet | Seongyul Ryu Ik Hyun Jo Seonhoo Kim Yeon-Ji Kim Woo Chul Chung |
| author_sort | Seongyul Ryu |
| collection | DOAJ |
| description | Background/Aims: Local and systemic factors, such as diabetes, obesity, and hyperlipidemia, are considered risk factors for the recurrence of choledocholithiasis after successful endoscopic clearance. Local factors include the presence of bile sludge, common
bile duct (CBD) diameter, and CBD angulation. Among them, it is unclear if acute CBD angulation is preferable to the recurrence of a CBD stone.
Methods: PubMed, EMBASE, CINAHL, the Cochrane Library databases, and google website were searched for randomized controlled trials reported in English and undertaken until August 2019. Meta‐analysis was performed on all randomized controlled trials for the recurrence of CBD stones between the patients with acute CBD angulation.
Results: Eight randomized trials (1,776 patients) were identified, and the total recurrent rate of CBD stones was 18.8% (334/1,776). A CBD angle ≤145° was significantly associated with an increased risk of recurrent CBD stone (OR=2.65, p<0.01). In two prospective studies, acute CBD angulation was not proven to be associated with a recurrence (p=0.39).
Conclusions: Approximately 20% of patients with a CBD stone showed recurrence after the complete clearance of the CBD stone, and a CBD angle ≤145° could increase the risk of recurrence. Overall, a large-scale prospective study should be necessary. |
| first_indexed | 2024-12-19T22:58:12Z |
| format | Article |
| id | doaj.art-b234551a8f5f45c9a17b756c174f9c60 |
| institution | Directory Open Access Journal |
| issn | 1598-9992 2233-6869 |
| language | English |
| last_indexed | 2024-12-19T22:58:12Z |
| publishDate | 2020-10-01 |
| publisher | Jin Publishing & Printing Co. |
| record_format | Article |
| series | The Korean Journal of Gastroenterology |
| spelling | doaj.art-b234551a8f5f45c9a17b756c174f9c602022-12-21T20:02:35ZengJin Publishing & Printing Co.The Korean Journal of Gastroenterology1598-99922233-68692020-10-0176419920510.4166/kjg.2020.76.4.199Clinical Impact of Common Bile Duct Angulation on the Recurrence of Common Bile Duct Stone: A Meta-analysis and ReviewSeongyul Ryu0Ik Hyun Jo1Seonhoo Kim2Yeon-Ji Kim3Woo Chul Chung4Division of Gastroenterology, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, KoreaDivision of Gastroenterology, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, KoreaDivision of Gastroenterology, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, KoreaDivision of Gastroenterology, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, KoreaDivision of Gastroenterology, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, KoreaBackground/Aims: Local and systemic factors, such as diabetes, obesity, and hyperlipidemia, are considered risk factors for the recurrence of choledocholithiasis after successful endoscopic clearance. Local factors include the presence of bile sludge, common bile duct (CBD) diameter, and CBD angulation. Among them, it is unclear if acute CBD angulation is preferable to the recurrence of a CBD stone. Methods: PubMed, EMBASE, CINAHL, the Cochrane Library databases, and google website were searched for randomized controlled trials reported in English and undertaken until August 2019. Meta‐analysis was performed on all randomized controlled trials for the recurrence of CBD stones between the patients with acute CBD angulation. Results: Eight randomized trials (1,776 patients) were identified, and the total recurrent rate of CBD stones was 18.8% (334/1,776). A CBD angle ≤145° was significantly associated with an increased risk of recurrent CBD stone (OR=2.65, p<0.01). In two prospective studies, acute CBD angulation was not proven to be associated with a recurrence (p=0.39). Conclusions: Approximately 20% of patients with a CBD stone showed recurrence after the complete clearance of the CBD stone, and a CBD angle ≤145° could increase the risk of recurrence. Overall, a large-scale prospective study should be necessary.http://www.kjg.or.kr/journal/view.html?uid=5628&vmd=Fullcommon bile ductcholedocholithiasisrecurrence |
| spellingShingle | Seongyul Ryu Ik Hyun Jo Seonhoo Kim Yeon-Ji Kim Woo Chul Chung Clinical Impact of Common Bile Duct Angulation on the Recurrence of Common Bile Duct Stone: A Meta-analysis and Review The Korean Journal of Gastroenterology common bile duct choledocholithiasis recurrence |
| title | Clinical Impact of Common Bile Duct Angulation on the Recurrence of Common Bile Duct Stone: A Meta-analysis and Review |
| title_full | Clinical Impact of Common Bile Duct Angulation on the Recurrence of Common Bile Duct Stone: A Meta-analysis and Review |
| title_fullStr | Clinical Impact of Common Bile Duct Angulation on the Recurrence of Common Bile Duct Stone: A Meta-analysis and Review |
| title_full_unstemmed | Clinical Impact of Common Bile Duct Angulation on the Recurrence of Common Bile Duct Stone: A Meta-analysis and Review |
| title_short | Clinical Impact of Common Bile Duct Angulation on the Recurrence of Common Bile Duct Stone: A Meta-analysis and Review |
| title_sort | clinical impact of common bile duct angulation on the recurrence of common bile duct stone a meta analysis and review |
| topic | common bile duct choledocholithiasis recurrence |
| url | http://www.kjg.or.kr/journal/view.html?uid=5628&vmd=Full |
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