Year 2020 / Volume 112 / Number 8
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Year 2020 / Volume 112 / Number 8

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Differences between residual and primary choledocholithiasis in cholecystectomy patients

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José Ruiz Pardo, Andrés García Marín, Francisco Javier Ruescas García, Miguel Jurado Román, Marcelo Scortechini, María Pilar Sagredo Rupérez, Juan Valiente Carrillo,

Introduction: choledocholithiasis can be primary from stones originally formed in the choledocho or secondary from stones that have migrated from the gallbladder to the choledocho. The objective of this study was to determine the clinical differences between both types of choledocholithiasis in cholecystectomy patients. Material and methods: a comparative and retrospective study was performed of cholecystectomy patients who presented choledocholithiasis. Residual or secondary choledocholithiasis (group 1) was defined as those which appear in the first two years after cholecystectomy and primary choledocholithiasis (group 2) was defined as those which appear two years after cholecystectomy. Choledocholithiasis was confirmed by endoscopic retrograde cholangiopancreatography (ERCP) or surgery. Results: patients with primary choledocholithiasis (n = 14) were older (61.5 ± 20.3 vs 74.4 ± 10.5 years; p = 0.049) and had a greater body mass index (BMI) (27.7 ± 4.3 vs 31.6 ± 4.6 kg/m2; p = 0.043) and a larger extrahepatic bile duct diameter (10.7 ± 2.7 vs 14.7 ± 3.5 mm; p = 0.004) compared to patients with residual or secondary choledocholithiasis (n = 11). All patients were treated by ERCP. There were no differences between groups 1 and 2 regarding recurrences (36.2 % vs 14.3 %; p = 0.350), disease-free survival (64.6 ± 30.9 vs 52.2 ± 37.7 months; p = 0.386) and overall survival (73.6 ± 32.4 vs 54 ± 41.9 months; p = 0.084). Conclusions: patients with primary choledocholithiasis were older and had a greater BMI and a larger diameter of the bile duct compared to patients with residual or secondary choledocholithiasis. ERCP is a good therapeutic option for the resolution of both types of choledocholithiasis.

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Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
© 2020 The Spanish Journal of Gastroenterology