Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website http://www.gastrores.org

Original Article

Volume 12, Number 4, August 2019, pages 191-197

Prophylactic Biliary Stenting Before Cholecystectomy in Patients With Gallstones and Common Bile Duct Stones

Figure 1. A flow chart of the clinical strategy for the management of CBDS concomitant with GS in the present study. CBDS: common bile duct stones; GS: gallstones; ERC: endoscopic retrograde cholangiography; EST: endoscopic sphincterotomy; CT: computed tomography; MRCP: magnetic resonance cholangiopancreatography.

**Table 1.** Patient Characteristics According to the Change in the Number of CBDS Between First and Second ERC
	Total (n = 39)
GS: gallstones; CBDS: common bile duct stones; ERC: endoscopic retrograde cholangiography.
Sex, n (%)
Male	20 (51)
Female	19 (49)
Median age (range)	68 (40 - 89)
Maximal diameter of GS (mm)
Median (range)	7 (2 - 30)
Patients with multiple GS (≥ 5)	21
Cholangitis on admission, n (%)
Yes	15 (38)
No	24 (62)
Maximal diameter of CBDS at first ERC (mm)
Median (range)	5 (0 - 11)
Patients with multiple CBDS (≥5)	6
Minimal diameter of cystic duct
Median (range)	4 (1 - 8)
Residual CBDS at first ERC
Yes	5 (12)
No	34 (88)
Days between first ERC and operation
Median (range)	26 (2 - 131)
Laparoscopic cholecystectomy, n (%)
Yes	37 (95)
No	2 (5)
Operation time (min)
Median (range)	95 (48 - 260)
Days between operation and second ERC
Median (range)	41 (26 - 96)
Maximal diameter of CBDS at second ERC (mm)
Median (range)	0 (0 - 10)
Patients with multiple CBDS (≥ 5)	2

Table 1. Patient Characteristics According to the Change in the Number of CBDS Between First and Second ERC

Total (n = 39)

GS: gallstones; CBDS: common bile duct stones; ERC: endoscopic retrograde cholangiography.

Sex, n (%)

Male

20 (51)

Female

19 (49)

Median age (range)

68 (40 - 89)

Maximal diameter of GS (mm)

Median (range)

7 (2 - 30)

Patients with multiple GS (≥ 5)

Cholangitis on admission, n (%)

Yes

15 (38)

24 (62)

Maximal diameter of CBDS at first ERC (mm)

Median (range)

5 (0 - 11)

Patients with multiple CBDS (≥5)

Minimal diameter of cystic duct

Median (range)

4 (1 - 8)

Residual CBDS at first ERC

Yes

5 (12)

34 (88)

Days between first ERC and operation

Median (range)

26 (2 - 131)

Laparoscopic cholecystectomy, n (%)

Yes

37 (95)

2 (5)

Operation time (min)

Median (range)

95 (48 - 260)

Days between operation and second ERC

Median (range)

41 (26 - 96)

Maximal diameter of CBDS at second ERC (mm)

Median (range)

0 (0 - 10)

Patients with multiple CBDS (≥ 5)

**Table 2.** Patient Characteristics According to Change in the Number of CBDS Between First and Second ERC
Variables	Change in number of CBDS between first and second ERC	P value
Results are presented as the number (n) or mean n (%) for qualitative data or as the median (range) for quantitative data. *P < 0.05. GS: gallstones; CBDS: common bile duct stones; ERC: endoscopic retrograde cholangiography.
Gender, female	7 (46.6%)	12 (50%)	0.55
Age, years	71 (40-89)	66 (45-84)	0.211
Maximum diameter of GS, mm	7 (2-22)	7 (2-30)	0.233
Patients with multiple GS (≥ 5)	9 (60%)	12 (50%)	0.55
Cholangitis on admission	5 (33.3%)	10 (41.6%)	0.43
Maximum diameter of CBDS, mm	4 (0 - 11)	5 (0 - 11)	0.976
Patients with multiple CBDS (≥ 5)	4 (26.6%)	2 (8.3%)	0.139
Minimal diameter of cystic duct, mm	5 (1 - 8)	3 (1 - 7)	0.022*
Residual CBDS at first ERC	0 (0%)	5 (20.8%)	0.074
Days between first ERC and operation	28 (12 - 131)	23 (2 - 97)	0.176
Laparoscopic cholecystectomy	13 (86.6%)	24 (100%)	0.142
Operation time, min	95 (56 - 163)	94 (48 - 260)	0.959
Days between operation and second ERC	44 (31 - 92)	40 (26 - 96)	0.866

Table 2. Patient Characteristics According to Change in the Number of CBDS Between First and Second ERC

Variables

Change in number of CBDS between first and second ERC

P value

Increased (group A) (n = 15)

Unchanged or decreased (group B) (n = 24)

Results are presented as the number (n) or mean n (%) for qualitative data or as the median (range) for quantitative data. *P < 0.05. GS: gallstones; CBDS: common bile duct stones; ERC: endoscopic retrograde cholangiography.

Gender, female

7 (46.6%)

12 (50%)

0.55

Age, years

71 (40-89)

66 (45-84)

0.211

Maximum diameter of GS, mm

7 (2-22)

7 (2-30)

0.233

Patients with multiple GS (≥ 5)

9 (60%)

12 (50%)

0.55

Cholangitis on admission

5 (33.3%)

10 (41.6%)

0.43

Maximum diameter of CBDS, mm

4 (0 - 11)

5 (0 - 11)

0.976

Patients with multiple CBDS (≥ 5)

4 (26.6%)

2 (8.3%)

0.139

Minimal diameter of cystic duct, mm

5 (1 - 8)

3 (1 - 7)

0.022*

Residual CBDS at first ERC

0 (0%)

5 (20.8%)

0.074

Days between first ERC and operation

28 (12 - 131)

23 (2 - 97)

0.176

Laparoscopic cholecystectomy

13 (86.6%)

24 (100%)

0.142

Operation time, min

95 (56 - 163)

94 (48 - 260)

0.959

Days between operation and second ERC

44 (31 - 92)

40 (26 - 96)

0.866

**Table 3.** Factors Associated With the Development of Recurrent CBDS After Endoscopic Treatment for CBDS Around the Perioperative Period in Cholecystectomy
	Univariate OR (95% CI)	P value	Multivariate OR (95% CI)	P value
Results are presented as a number (n) or mean n (%) for qualitative data or as median (range) for quantitative data. *P < 0.05. GS: gallstones; CBDS: common bile duct stones; ERC: endoscopic retrograde cholangiography; CI: confidence interval.
Gender, female	1.143 (0.314 - 4.160)	0.839
Age, years	0.961 (0.903 - 1.023)	0.211
Maximum diameter of GS, mm	1.083 (0.949 - 1.236)	0.238
Patients with multiple GS (≥ 5)	1.143 (0.314 - 4.160)	0.839
Cholangitis on admission	1.429 (0.372 - 5.487)	0.603
Maximum diameter of CBDS, mm	0.997 (0.816 - 1.218)	0.975
Patients with multiple CBDS (≥ 5)	0.250 (0.039 - 1.582)	0.141	0.218 (0.030 - 1.586)	0.132
Minimal diameter of cystic duct, mm	0.664 (0.459 - 0.962)	0.03*	0.611 (0.398 - 0.939)	0.025*
Residual CBDS at first ERC		0.999
Days between first ERC and operation	0.984 (0.962 - 1.008)	0.185	0.974 (0.946 - 1.003)	0.084
Laparoscopic cholecystectomy		0.999
Operation time, min	1.000 (0.984 - 1.017)	0.958
Days between operation and second ERC	0.997 (0.959 - 1.036)	0.862

Table 3. Factors Associated With the Development of Recurrent CBDS After Endoscopic Treatment for CBDS Around the Perioperative Period in Cholecystectomy

Univariate OR (95% CI)

P value

Multivariate OR (95% CI)

P value

Results are presented as a number (n) or mean n (%) for qualitative data or as median (range) for quantitative data. *P < 0.05. GS: gallstones; CBDS: common bile duct stones; ERC: endoscopic retrograde cholangiography; CI: confidence interval.

Gender, female

1.143 (0.314 - 4.160)

0.839

Age, years

0.961 (0.903 - 1.023)

0.211

Maximum diameter of GS, mm

1.083 (0.949 - 1.236)

0.238

Patients with multiple GS (≥ 5)

1.143 (0.314 - 4.160)

0.839

Cholangitis on admission

1.429 (0.372 - 5.487)

0.603

Maximum diameter of CBDS, mm

0.997 (0.816 - 1.218)

0.975

Patients with multiple CBDS (≥ 5)

0.250 (0.039 - 1.582)

0.141

0.218 (0.030 - 1.586)

0.132

Minimal diameter of cystic duct, mm

0.664 (0.459 - 0.962)

0.03*

0.611 (0.398 - 0.939)

0.025*

Residual CBDS at first ERC

0.999

Days between first ERC and operation

0.984 (0.962 - 1.008)

0.185

0.974 (0.946 - 1.003)

0.084

Laparoscopic cholecystectomy

0.999

Operation time, min

1.000 (0.984 - 1.017)

0.958

Days between operation and second ERC

0.997 (0.959 - 1.036)

0.862