Repeated ERCP for the Management of Recurrent CBD Stones
نویسنده
چکیده
Introduction The recurrence rate of choledocholithiasis after endoscopic stone extraction differs from 6.4% to 24%. Although the etiology of stone recurrence after initial ERCP has not been fully elucidated, some risk factors for stone recurrence have been reported: a common bile duct (CBD) dilatation, periampullary diverticula (PAD), pneumobilia, and acute CBD angulation. The early detection and treatment of recurrent CBD stones may help to avoid life threatening complications such as acute suppurative cholangitis and septic shock. Several studies have reported that regular clinical follow-up of patients after CBD stones removal is valuable and it decreases the morbidity related to stone recurrence. However, early detection of CBD stone is not easy even after physical examinations, biochemical tests, ultrasonography, computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP). In addition, follow-up ERCP has been proven to be safer than the initial ERCP. Therefore, the ideal follow-up strategy after CBD stone removal is to follow up the high risk patients with ERCP.
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