Abstract
Background: Calculi analysis is helpful for estimating the origin of gallstones; however, whilst a number of studies have analyzed the components of gallstones there have not been many reports about the components of common bile duct stones. Methods: We investigated the correlation between the constituents of common bile duct stones and recurrence. A total of 122 patients underwent endoscopic retrograde cholangiopancreatography, and the data obtained from calculi analysis in these cases were analyzed retrospectively. The subjects' backgrounds, the effectiveness of cholecystectomy at preventing recurrence, and the constituents of initial and recurrent stones were examined. Results: Cholesterol gallstones, pigmented gallstones, and uncommon gallstones accounted for 24.6%, 63.9%, and 11.5%, respectively, of the gallstones encountered in this study. Age, the frequency of obesity, common bile duct diameter, and stone diameter differed significantly among the three groups (p<0.01, p=0.041, p=0.012, and p=0.011, respectively). Cholecystectomy decreased the recurrence rate in the cholesterol gallstone group (p=0.035), but not in the other groups. The constituents of the initial and recurrent stones did not differ in seven out of eight patients. Conclusion: The ability of cholecystectomy to prevent bile duct stone recurrence depends on the type of calculi involved. Calculi analysis might facilitate the development of more individualized prevention strategies against recurrent common bile duct stones.
