Journal of Practical Hepatology ›› 2025, Vol. 28 ›› Issue (4): 629-632.doi: 10.3969/j.issn.1672-5069.2025.04.038

• Cholelithiasis • Previous Articles     Next Articles

Influencing factors on postoperative stone residual and recurrence in patients with intrahepatic bile duct stones after partial hepatectomy and cholangioenterostomy

Wang Haoyu, Shi Danghui, Mao Yufeng   

  1. Department of Hepatobiliary Surgery, People's Hospital, Tongchuan 727031, Shaanxi Province, China
  • Received:2024-09-02 Online:2025-07-10 Published:2025-07-14

Abstract: Objective The aim of this study was to investigate influencing factors on postoperative stone residual and recurrence in patients with intrahepatic bile duct stones (IHBDS) after partial hepatectomy (ph) and cholangioenterostomy. Methods 50 patients with IHBDS were encountered in our hospital between January 2019 and January 2022, all underwent PH and choledochojejunostomy and were followed-up for one year. Serum C-reactive protein (CRP) and interleukin- 6 (IL-6) levels were detected by ELISA. Multivariate Logistic regression analysis was applied to predict impacting factors of stone residual or recurrence. Results By end of one-year follow-up, stoneresidual was found by imaging in 10 cases (20.0%) among our 50 patients with IHBDS; at baseline, percentages of bilateral lobe bile stone, common bile duct diameter ≥15 mm and biliary stricture in patients with residual stone or recurrence were 60.0%, 60.0% and 80.0%, all much higher than 20.0%, 20.0% and 35.0% (P<0.05) in patients without; at presentation, white blood cell count, serum CRP, GGT and IL-6 levels in patients with stone residual were (7.9±0.9)×109/L, (52.7±4.6)mg/L, (252.7±27.4)U/L and (92.5±14.3)μg/L, all significantly higher than [(4.6±0.8)×109/L, (25.6±3.0)mg/L, (143.5±26.0)U/L and (65.3±15.2)μg/L, respectively, P<0.05] in patients without; multivariate Logistic regression analysis showed that bilateral lobe bile stone, common bile duct diameter ≥15 mm and biliary stricture were all the independent risk factors for stone residual or recurrence(OR=3.536, OR=3.695,OR=3.404, respectively, P<0.05). Conclusion The main problem after PH and cholangioenterostomy in patients with IHBDS is stone residual or recurrence, and how to tackle it still need further clinical investigation.

Key words: Intrahepatic bile duct stones, Partial hepatectomy, Cholangioenterostomy, Residual stone, Recurrence, Influencing factors