Clinical Features of Impacted Common Bile Duct Stones at Duodenal Papilla.

Autor:	Lee JM; Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea., Lee SH; Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea., Kim JH; Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea., Kim TS; Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea., Chang SH; Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea., Kim SH; Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea., Lee JH; Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea., Kang CD; Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea., Park JM; Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea.
Jazyk:	angličtina
Zdroj:	The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi [Korean J Gastroenterol] 2024 Dec 25; Vol. 84 (6), pp. 274-281.
DOI:	10.4166/kjg.2024.099
Abstrakt:	Background/aims: Urgent endoscopic removal is required for gallstones impacted at the duodenal papilla. This study compared the clinical features of impacted papillary stones (IPS) with those of common bile duct stones without impaction. Methods: This study analyzed a common bile duct stone database from 2017 to 2023, identifying patients with IPS. The clinical features of IPS were compared with those of common bile duct stones without IPS (NIPS). Results: One hundred and eighty patients were analyzed; 45 had IPS. The mean age was 63.9 years, with a male predominance in the IPS group. The success rates of selective biliary cannulation were comparable between the IPS and NIPS groups. Multivariate analysis showed that IPS was associated with pancreatitis (odds ratio [OR] 3.78, 95% confidence interval [CI]: 1.17-12.17, p=0.026), bile duct penetrating duodenal wall sign (BPDS, OR 12.09, 95% CI: 3.92-37.33, p<0.001), and the presence of pus (OR 27.05, 95% CI: 4.92-148.85, p<0.001). The periampullary diverticulum (OR 0.28, 95% CI: 0.10-0.82, p=0.021) and the largest stone ≥10 mm (OR 0.31, 95% CI: 0.10-0.96, p=0.043) were inversely correlated with IPS. Conclusions: IPS are associated with pancreatitis, BPDS, and acute suppurative cholangitis, whereas periampullary diverticulum and the stone size are inversely correlated with IPS.
Databáze:	MEDLINE
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