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BMC Gastroenterology
Published in: BMC Gastroenterology 1/2018

Open Access 01-12-2018 | Research article

Gallbladder function predicts subsequent biliary complications in patients with common bile duct stones after endoscopic treatment?

Authors: Tzung-Jiun Tsai, Hoi-Hung Chan, Kwok-Hung Lai, Chih-An Shih, Sung-Shuo Kao, Wei-Chih Sun, E-Ming Wang, Wei-Lun Tsai, Kung-Hung Lin, Hsien-Chung Yu, Wen-Chi Chen, Huay-Min Wang, Feng-Woei Tsay, Huey-Shyan Lin, Jin-Shiung Cheng, Ping-I Hsu

Published in: BMC Gastroenterology | Issue 1/2018

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Abstracts

Background

In patients with common bile duct stones (CBDS) and intact gallbladder, further management for the gallbladder after the CBDS clearance is still controversial. The relationship between gallbladder motility and the biliary complications were seldom discussed. Our study is to predict the subsequent biliary complications by gallbladder function test using fatty meal sonography (FMS) in patients with CBDS who had been treated by endoscopic retrograde cholangiopancreatography (ERCP).

Methods

Patients with an intact gallbladder and CBDS after endoscopic clearance of bile duct were enrolled. Patients received a fatty meal sonography after liver function returned to normal. The fasting volume, residual volume, and gallbladder ejection fraction (GBEF) in FMS were measured. Relationships of patients’ characteristics, gallbladder function and recurrent biliary complication were analyzed.

Results

From 2011 to 2014, 118 patients were enrolled; 86 patients had calculus gallbladders, and 32 patients had acalculous gallbladders. After a mean follow- up of 33 months, 23 patients had recurrent biliary complications. Among 86 patients with calculus gallbladder, 15 patients had spontaneous clearance of gallbladder stones; 14 patients received cholecystectomy due to acute cholecystitis or recurrent colic pain with smooth postoperative courses. In the follow up period, six patients died of non-biliary causes. The GBEF is significant reduced in most patients with a calculus gallbladder in spite of stone color. Calculus gallbladder, alcohol drinking and more than one sessions of initial endoscopic treatment were found to be the risk factors of recurrent biliary complication.

Conclusions

Gallbladder motility function was poorer in patients with a calculus gallbladder, but it cannot predict the recurrent biliary complication. Since spontaneous clearance of gallbladder stone may occur, wait and see policy of gallbladder management after endoscopic treatment of CBDS is appropriate, but regular follow- up in those patients with risk factors for recurrence is necessary.
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Metadata
Title
Gallbladder function predicts subsequent biliary complications in patients with common bile duct stones after endoscopic treatment?
Authors
Tzung-Jiun Tsai
Hoi-Hung Chan
Kwok-Hung Lai
Chih-An Shih
Sung-Shuo Kao
Wei-Chih Sun
E-Ming Wang
Wei-Lun Tsai
Kung-Hung Lin
Hsien-Chung Yu
Wen-Chi Chen
Huay-Min Wang
Feng-Woei Tsay
Huey-Shyan Lin
Jin-Shiung Cheng
Ping-I Hsu
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2018
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-018-0762-6

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