Clinical Features of Impacted Common Bile Duct Stones at Duodenal Papilla
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 databa...
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| Format: | Article |
| Language: | English |
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Jin Publishing & Printing Co.
2024-12-01
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| Series: | The Korean Journal of Gastroenterology |
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| Online Access: | https://www.kjg.or.kr/journal/view.html?uid=6069&vmd=Full |
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| author | Jae Min Lee Sang Hoon Lee Ji Hyun Kim Tae Suk Kim Sung Hoon Chang San Ha Kim Jung Ho Lee Chang Don Kang Jin Myung Park |
| author_facet | Jae Min Lee Sang Hoon Lee Ji Hyun Kim Tae Suk Kim Sung Hoon Chang San Ha Kim Jung Ho Lee Chang Don Kang Jin Myung Park |
| author_sort | Jae Min Lee |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-131f01fa1cae4243b84cbb6349b12b0e |
| institution | Kabale University |
| issn | 1598-9992 2233-6869 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Jin Publishing & Printing Co. |
| record_format | Article |
| series | The Korean Journal of Gastroenterology |
| spelling | doaj-art-131f01fa1cae4243b84cbb6349b12b0e2025-01-06T05:53:31ZengJin Publishing & Printing Co.The Korean Journal of Gastroenterology1598-99922233-68692024-12-0184627428110.4166/kjg.2024.099Clinical Features of Impacted Common Bile Duct Stones at Duodenal PapillaJae Min Lee0Sang Hoon Lee1Ji Hyun Kim2Tae Suk Kim3Sung Hoon Chang4San Ha Kim5Jung Ho Lee6Chang Don Kang7Jin Myung Park8https://orcid.org/0000-0002-8798-0587Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, KoreaDepartment of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, KoreaDepartment of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, KoreaDepartment of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, KoreaDepartment of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, KoreaDepartment of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, KoreaDepartment of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, KoreaDepartment of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, KoreaDepartment of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, KoreaBackground/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.https://www.kjg.or.kr/journal/view.html?uid=6069&vmd=Fullgallstonescommon bile ductcholangiopancreatographyendoscopic retrogradeampulla of vaterpancreatitis |
| spellingShingle | Jae Min Lee Sang Hoon Lee Ji Hyun Kim Tae Suk Kim Sung Hoon Chang San Ha Kim Jung Ho Lee Chang Don Kang Jin Myung Park Clinical Features of Impacted Common Bile Duct Stones at Duodenal Papilla The Korean Journal of Gastroenterology gallstones common bile duct cholangiopancreatography endoscopic retrograde ampulla of vater pancreatitis |
| title | Clinical Features of Impacted Common Bile Duct Stones at Duodenal Papilla |
| title_full | Clinical Features of Impacted Common Bile Duct Stones at Duodenal Papilla |
| title_fullStr | Clinical Features of Impacted Common Bile Duct Stones at Duodenal Papilla |
| title_full_unstemmed | Clinical Features of Impacted Common Bile Duct Stones at Duodenal Papilla |
| title_short | Clinical Features of Impacted Common Bile Duct Stones at Duodenal Papilla |
| title_sort | clinical features of impacted common bile duct stones at duodenal papilla |
| topic | gallstones common bile duct cholangiopancreatography endoscopic retrograde ampulla of vater pancreatitis |
| url | https://www.kjg.or.kr/journal/view.html?uid=6069&vmd=Full |
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